護理師準備給予心衰竭病人 digoxin 0.25 mg，測量心尖脈為 54 bpm。護理師應優先採取何種行動？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Before administration, the nurse checks the apical pulse and finds it to be 54 bpm. What is the priority nursing action?
- AGive half of the prescribed dose給予處方劑量的一半
- BWithhold the dose and notify the provider✓ 正解暫停給藥並通知醫師
- CAdminister the medication as ordered依指示給藥
- DReassess the pulse in 30 minutes30 分鐘後重新評估脈搏
Digoxin 具負性變時作用，成人心率低於 60 bpm 時應暫停給藥以預防嚴重心搏過緩或毒性。護理師必須主動防範藥物不良反應，並回報醫師以確認是否需調整劑量。重複測量或減量皆不符合標準安全給藥程序。
Digoxin has a negative chronotropic effect, and in adults whose heart rate is below 60 bpm, the dose should be held to prevent severe bradycardia or toxicity. The nurse must actively guard against adverse drug effects and report to the physician to determine whether the dose needs to be adjusted. Repeating the measurement or reducing the dose unilaterally does not meet the standard safe medication administration procedure.
美台臨床對於 Digoxin 給藥心跳門檻皆為 60 bpm，惟美國護理師常有權依 Protocol 暫停，台灣亦執行一致。