— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心衰竭病人地高辛（Digoxin），哪項評估結果需要暫停給藥？
A nurse is administering digoxin to a client with heart failure. Which assessment finding requires the nurse to withhold the medication?
- AApical pulse of 52 beats/minute✓ 正解心尖脈搏為每分鐘52次
- BBlood pressure of 110/70 mmHg血壓為110/70 mmHg
- CRespiratory rate of 18 breaths/minute呼吸頻率為每分鐘18次
- DSerum potassium level of 4.2 mEq/L血清鉀濃度為4.2 mEq/L
— Explanation · 中文詳解 —
地高辛具有負性變時作用，若心跳過慢（成人 <60 bpm）會導致心輸出量不足，增加心律不整風險。臨床給藥前必須確實執行心尖搏動測量滿一分鐘，若數值過低應立刻停止給藥並通知醫師，以防藥物中毒引發嚴重緩慢性心律不整。
Digoxin has a negative chronotropic effect. A heart rate that is too slow (adult <60 bpm) leads to inadequate cardiac output and increases the risk of dysrhythmias. Before administration, the apical pulse must be measured for one full minute; if the rate is too low, the dose must be held and the physician notified to prevent severe bradydysrhythmias from digoxin toxicity.
✦ 台美臨床差異
台美臨床皆嚴格執行給藥前心跳評估，但台灣護理資訊系統常會自動鎖定給藥功能。