— 藥理與非經腸給藥 · MEDIUM · MCQ —
心衰竭病人在服用毛地黃（Digoxin）前，哪項評估結果需要護理師暫停給藥？
Which assessment finding requires the nurse to hold the scheduled dose of digoxin for a client with heart failure?
- ADigoxin level 0.8 ng/mL毛地黃濃度 0.8 ng/mL
- BApical pulse 52 beats/min✓ 正解心尖脈搏 52 次/分
- CPotassium level 3.8 mEq/L鉀離子濃度 3.8 mEq/L
- DBlood pressure 110/70 mmHg血壓 110/70 mmHg
— Explanation · 中文詳解 —
Digoxin 具有負向傳導作用，會減慢心跳。臨床標準為成人心跳若低於 60 次/分，或兒童低於 70-90 次/分，必須暫停給藥並通知醫師。心跳過慢可能導致心排血量不足，增加心臟毒性風險，因此評估心尖脈至關重要。
Digoxin has a negative conductive effect and slows the heart rate. The clinical standard is to hold the dose and notify the provider if the heart rate is below 60 bpm in an adult or below 70-90 bpm in a child. Bradycardia may lead to inadequate cardiac output and increases the risk of cardiac toxicity, so assessing the apical pulse is essential.
✦ 台美臨床差異
台灣醫院常規下，護理師需在給藥卡上記錄給藥前脈搏；美國則更強調自主臨床判斷與電子病歷紀錄。