— 藥理與非經腸給藥 · EASY · MCQ —
對於成人病人，下列哪項評估結果需要護理師暫停給予地高辛（Digoxin）？
Which assessment finding requires the nurse to hold the administration of digoxin in an adult client?
- ARespiratory rate of 18 breaths per minute呼吸速率為每分鐘 18 次
- BApical pulse of 54 beats per minute✓ 正解心尖脈搏為每分鐘 54 次
- CBlood pressure of 110/70 mmHg血壓為 110/70 mmHg
- DPotassium level of 4.0 mEq/L鉀離子濃度為 4.0 mEq/L
— Explanation · 中文詳解 —
地高辛具有負性變時作用（減慢心跳）。成人給藥前的標準評估為測量心尖脈，若低於 60 次/分則需暫停給藥並通知醫師，以防嚴重心搏過緩。血壓與呼吸頻率在此情況下非直接影響因子，而血鉀 4.0 mEq/L 處於正常範圍，不影響藥物吸收與代謝。
Digoxin has a negative chronotropic effect and slows the heart rate. The standard pre-administration assessment in adults is to measure the apical pulse; if it is below 60 beats per minute, the medication must be held and the provider notified to prevent severe bradycardia. Blood pressure and respiratory rate are not direct contraindications in this setting, and a potassium level of 4.0 mEq/L is within the normal range and does not affect drug absorption or metabolism.
✦ 台美臨床差異
台美臨床對於成人給藥前心跳標準（<60 bpm）一致，但美國護理師常依醫師醫囑執行，台灣則較嚴格遵守標準程序。