— 藥理與非經腸給藥 · MEDIUM · SATA —
當為成年病人給予毛地黃（Digoxin）時，下列哪些護理措施是合適的？（選所有適合的）
Which of the following interventions are appropriate when administering digoxin to an adult client? (Select all that apply.)
- AAssess apical pulse for one full minute prior to administration✓ 正解給藥前測量心尖脈整整一分鐘
- BHold the dose if the pulse rate is less than 60 beats per minute✓ 正解若脈搏低於每分鐘 60 次則暫停給藥
- CMonitor serum potassium levels for potential hypokalemia✓ 正解監測血清鉀離子濃度以預防低血鉀
- DAdminister with a high-fiber meal to prevent constipation與高纖維餐點一起給藥以預防便秘
- ECheck for clinical signs of toxicity such as visual disturbances✓ 正解檢查是否有中毒的臨床徵兆，例如視覺障礙
— Explanation · 中文詳解 —
Digoxin 具狹窄治療範圍,給藥前必須確實測量心尖脈一分鐘,若低於 60 bpm 應暫停給藥以防心搏過緩。同時,低血鉀會增強毛地黃毒性,故需監測鉀離子濃度。視覺異常(如黃綠光視)為中毒早期指標。高纖食物會降低藥物吸收,故 D 為錯誤選項。
Before administering digoxin, the nurse must assess the apical pulse for one full minute and hold the dose if the rate is below 60 beats per minute to prevent bradycardia. Monitoring serum potassium is essential because hypokalemia increases the risk of digoxin toxicity, which may manifest as visual disturbances. High-fiber meals should be avoided as they can decrease drug absorption.
✦ 台美臨床差異
美國護理師對 Digoxin 給藥標準化程度極高，台灣實務上常依各醫院 policy 調整給藥前的心跳閾值。