# 一位患有嚴重惡性腫瘤高血鈣的病患已接受降鈣素治療 4 天，但鈣反應已趨於平穩。護理師應澄清哪項醫囑？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522671&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位患有嚴重惡性腫瘤高血鈣的病患已接受降鈣素治療 4 天，但鈣反應已趨於平穩。護理師應澄清哪項醫囑？

## 選項

1. 治療期間繼續監測腎功能和體液狀態。
2. 審查持續的抗骨吸收治療以維持鈣質控制。
3. 儘管已趨於平穩，仍無限期單獨繼續使用降鈣素。 **✔ 正確答案**
4. 重新評估症狀和連續校正後的鈣結果。

**正確答案: 3**

## 解析

降鈣素具有快速作用，但應限於短期療程，因為會產生快速耐受性。持續控制需要適當的抗骨吸收治療，而非無限期的降鈣素單一療法。

## 深入解析

快速解答
質疑反應趨於平穩後延長降鈣素單一療法。

為何這是正確的
病患仍需要症狀、鈣、腎功能和體液的再評估，同時長期作用的療法處理持續的惡性腫瘤引起的鈣釋放。

簡單類比或心像
將每次輸注視為一個受控的臨床系統：核對產品和通路，辨識變化的徵兆，停止可預防的暴露，穩定病患，並確認反應。

記憶點
產品、通路、相容性、輸注徵兆、保護措施和再評估。

NCLEX 決策原則
選擇能預防最即時輸注相關傷害的措施，同時保留血管通路和醫囑診斷證據。

為何其他選項是錯誤的
重新啟動可疑產品、繞過安全裝置、強行通過阻塞管路或延遲再評估的選項，可能將可逆的警訊轉變為嚴重傷害。References
1Endocrine Society Clinical Practice Guideline: Hypercalcemia of Malignancy in Adults初步水合、抗骨吸收治療、重症降鈣素、腎功能和體液評估以及結果監測。

## 臨床情境

血液製品、營養和靜脈輸液安全審查
核對產品、醫囑、途徑、通路裝置、過濾器或管路、相容性、基準發現、新出現的不良徵兆、反應計畫和可測量的後續追蹤。

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