— 藥理與非經腸給藥 · HARD · MCQ —
護理師欲給予一位心衰竭嬰兒毛地黃 (Digoxin)。下列何種發現應讓護理師暫停給藥？
A nurse is administering a dose of digoxin to an infant with heart failure. Which finding would cause the nurse to withhold the dose?
- AHeart rate of 160 bpm心率 160 bpm
- BHeart rate of 85 bpm✓ 正解心率 85 bpm
- CHeart rate of 110 bpm心率 110 bpm
- DHeart rate of 140 bpm心率 140 bpm
— Explanation · 中文詳解 —
嬰幼兒給予 Digoxin 的安全心跳標準通常為 90-100 bpm 以上。小於 90-100 bpm 可能代表藥物中毒引發心跳過慢，護理師應先暫停藥物並通知兒科醫師進行心電圖評估，以避免致命性心跳停止。
The safe heart-rate threshold for administering digoxin to infants is generally above 90–100 bpm. A rate below 90–100 bpm may indicate drug-induced bradycardia from digoxin toxicity; the nurse should hold the dose and notify the pediatrician for ECG evaluation to prevent potentially fatal cardiac arrest.
✦ 台美臨床差異
美台兒科用藥安全標準一致，但美國專科護理師 (PNP) 在決策上可能更有彈性，台灣兒科給藥嚴格遵循醫師醫囑範圍。