# 接受靜脈注射鴉片類藥物三十分鐘後，一名術後病人難以喚醒。呼吸為每分鐘 7 次且淺，血氧飽和度為 84%，瞳孔呈針狀。針對每組，選出所有適用的選項。

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=603013&lang=zh-tw  
> language: zh-TW  
> subject: Medical Emergencies  
> category: PA

## 題目

接受靜脈注射鴉片類藥物三十分鐘後，一名術後病人難以喚醒。呼吸為每分鐘 7 次且淺，血氧飽和度為 84%，瞳孔呈針狀。針對每組，選出所有適用的選項。

支持鴉片類藥物過量回應的發現

無法以聲音喚醒

呼吸緩慢且淺

針狀瞳孔

給予鴉片類藥物前切口疼痛評分為 6／10

立即回應行動

支持呼吸並啟動緊急協助

依緊急規範給予 naloxone

給予 naloxone 後眼睛一旦張開即讓病人獨處

催吐以排除鴉片類藥物

## 解析

無反應、呼吸緩慢淺快及針狀瞳孔支持鴉片類藥物過量。應支持通氣、呼叫緊急救援，並依規範給予 naloxone。由於鴉片類藥物毒性在給予 naloxone 後可能復發，因此需持續觀察。

## 深入解析

快速解答
線索：無法喚醒、呼吸緩慢淺快及針狀瞳孔。行動：支持呼吸／緊急應變及給予 naloxone。
為何此為最佳回應
靜脈注射鴉片類藥物後出現的此群症狀顯示有危及生命的呼吸抑制，因此通氣與逆轉劑不可延遲。
為何其他選項不適用
先前的疼痛無法解釋目前的呼吸衰竭。給予 naloxone 後的改善可能為暫時性，且催吐無法逆轉注射的鴉片類藥物。
**參考資料**
- CDC — What to Do If You Think Someone Is Overdosing

- CDC/NIOSH — Responding to a Suspected Opioid Overdose

## 重要概念

- **Naloxone** — 一種鴉片類拮抗劑，用於逆轉鴉片類藥物引起的呼吸抑制。
- **Recurrent toxicity** — 呼吸抑制在初步改善後可能復發，因此需要持續監測。

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