# 階段 2 — 分析線索。將每項發現與其最直接支持的臨床結論配對。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568877&lang=zh-tw  
> language: zh-TW  
> subject: Safety and Infection Prevention and Control  
> category: SIPC

## 題目

階段 2 — 分析線索。將每項發現與其最直接支持的臨床結論配對。

|  | Dopamine 拮抗劑暴露 | 自主神經不穩定 | NMS 動作型態 | 橫紋肌溶解症合併腎損傷 |
| --- | --- | --- | --- | --- |
| 重複給予 haloperidol 後接著較高的排定劑量 |  |  |  |  |
| 體溫 40.2°C 伴血壓不穩定及盜汗 |  |  |  |  |
| 全身性鉛管樣僵硬且無陣攣 |  |  |  |  |
| CK 6,800 U/L、肌紅蛋白尿、鉀 5.6 及 creatinine 上升 |  |  |  |  |

## 解析

快速增加 haloperidol 劑量確立了 dopamine 拮抗劑暴露，發燒伴血壓不穩定顯示自主神經不穩定，鉛管樣僵硬可區分 NMS 與以陣攣為主的 serotonin 毒性，而高 creatine kinase 伴肌紅蛋白尿及 creatinine 上升則表示橫紋肌溶解症合併腎損傷。

## 深入解析

快速解答
連結暴露、自主神經發現、僵硬型態及肌肉分解併發症。

為何正確
必須同時辨識診斷型態及下游損傷，因為高血鉀、心律不整及腎衰竭可能立即危及生命。

簡單比喻或心智圖像
藥物是觸發因子，自主神經不穩定與僵硬可辨識此症候群，深色尿液顯示器官損傷。

記憶口訣
觸發、不穩定、僵硬、橫紋肌溶解。

NCLEX 決策規則
分析動作型態及藥物暴露，同時篩檢併發症。

為何其他選項錯誤
沒有任何單一發現能解釋所有欄位：藥物暴露無法測量腎損傷，而 creatine kinase 無法描述自主神經型態。

參考資料
1Haloperidol Prescribing InformationNMS 表現、橫紋肌溶解症與腎損傷、立即停藥、密集支持性治療及復發注意事項

## 臨床情境

案例更新
護理師鑑別此症候群並辨識需要立即監測的併發症。

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