— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予病人 digoxin 0.25 mg 口服。若出現哪項評估結果，護理師應暫停給藥？
A nurse is administering digoxin 0.25 mg orally to a client. Which assessment finding requires the nurse to withhold the medication?
- ABlood pressure of 118/76 mmHg血壓 118/76 mmHg
- BPotassium level of 4.2 mEq/L鉀離子濃度 4.2 mEq/L
- CClient complains of mild nausea病人抱怨輕微噁心
- DApical heart rate of 52 beats per minute✓ 正解心尖心率 52 beats per minute
— Explanation · 中文詳解 —
Digoxin 具有正性肌力作用，但同時具備負性變時作用（Negative chronotropic effect），會減慢心跳。成人服用前，心跳若低於 60 次/分，即為暫停給藥的臨床硬指標（Hard stop），以防止嚴重的竇性心動過緩或房室傳導阻滯。雖然噁心也是中毒徵兆，但心跳數據是客觀且必須立即執行的評估項目。
Digoxin has positive inotropic effects but also has a negative chronotropic effect that slows the heart rate. In adults, a pulse below 60 beats per minute before a dose is a hard stop for administration, in order to prevent severe sinus bradycardia or atrioventricular block. Nausea can also indicate toxicity, but heart rate is an objective parameter that must be checked first.