# 一位因開始服用 lisinopril 後出現嘴唇及舌頭腫脹而接受治療的個案，目前狀況穩定，準備進行出院衛教。護理師應給予哪項關於藥物的指導？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522680&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

一位因開始服用 lisinopril 後出現嘴唇及舌頭腫脹而接受治療的個案，目前狀況穩定，準備進行出院衛教。護理師應給予哪項關於藥物的指導？

## 選項

1. 永久停用 lisinopril，並與醫師討論改用其他類別的藥物 **✔ 正確答案**
2. 以較低劑量重新開始服用 lisinopril，並回報任何腫脹復發
3. 今晚開始服用血管張力素受體阻斷劑以取代 lisinopril 劑量
4. 每次服用 lisinopril 前先服用抗組織胺以預防進一步腫脹

**正確答案: 1**

## 解析

ACE 抑制劑引起的血管性水腫可能更嚴重地復發，因此是停用此類藥物的理由。替代藥物應由醫師選擇，而非由個案自行開始服用。

## 深入解析

快速解答
永久停用此藥，並由醫師選擇替代藥物。

為什麼這是正確的
血管性水腫是緩激肽介導的類別效應，而非劑量相關，因此較低劑量仍具有相同風險。復發可能波及呼吸道，因此再次嘗試用藥並不安全。

簡單比喻或心智圖像
這是對整個類別的過敏性退出，而非調整速度。此比喻傳達永久性，同時將替代藥物的選擇留給處方醫師。

記憶掛鉤
ACE 抑制劑血管性水腫終結整個類別，而不只是該劑量。

NCLEX 決策規則
發生 ACE 抑制劑血管性水腫後，應停用該藥且不再嘗試。任何替代藥物，包括血管張力素受體阻斷劑，皆屬與醫師共同決定的處方決策。

為什麼其他選項是錯的
降低劑量、自行開始替代藥物及預先用藥，都會使個案持續暴露於可能波及呼吸道的反應。參考文獻

- [1]NCSBN: 2026 NCLEX-RN Test PlanNational Council of State Boards of Nursing

- [2]MedlinePlus: LisinoprilU.S. National Library of Medicine

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