# 哪位病人適合使用吩坦尼穿皮系統？

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522888&lang=zh-tw  
> language: zh-TW  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## 題目

哪位病人適合使用吩坦尼穿皮系統？

## 選項

1. 一位對鴉片類藥物耐受，且有嚴重持續性疼痛，需要持續全天候鴉片類藥物治療的病人 **✔ 正確答案**
2. 一位對鴉片類藥物不耐受，且有急性術後疼痛的病人
3. 一位有間歇性輕度疼痛，且希望按需給藥的病人
4. 一位發燒且對鴉片類藥物不耐受，並在貼敷部位使用熱敷墊的病人

**正確答案: 1**

## 解析

吩坦尼穿皮貼片僅適用於對鴉片類藥物耐受，且有嚴重持續性疼痛，需要持續治療的病人。它不適用於急性、術後、間歇性或對鴉片類藥物不耐受的病人，且外部熱源會增加吸收。

## 深入解析

快速解答
需要鴉片類藥物耐受、持續性疼痛且無熱暴露。

為何這是正確的
貼片給藥持續數天，無法像短效急救劑量那樣進行滴定。

簡單類比或心像
建立藥物安全鏈：識別新的線索，將其與藥物機制或標示限制連結，停止可預防的暴露，穩定病人，並驗證可測量的反應。

記憶點
藥物、緊急線索、保護措施和再評估終點。

NCLEX決策規則
選擇能預防最直接藥物相關傷害的措施，同時保留指示治療和必要的監測。

為何其他選項是錯誤的
繼續可疑暴露、將標示的危險線索正常化、替代未經授權的劑量或延遲升級的選項會使病人處於危險之中。參考資料
1DailyMed: Fentanyl Transdermal System鴉片類藥物耐受適應症和致命的熱相關吸收風險

## 臨床情境

藥物安全審查
確認適應症、當前評估、劑量和途徑、器官功能、交互作用、緊急毒性線索、授權行動和可測量的後續追蹤。

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