護理師準備給予病人地高辛（Digoxin）。給藥前應完成哪些評估？（選所有適合的）
A nurse is preparing to administer medications to a client. Which assessments should the nurse complete before administering Digoxin? (Select all that apply.)
- AApical pulse rate✓ 正解心尖脈搏速率
- BSerum potassium level✓ 正解血清鉀濃度
- CBlood pressure血壓
- DVision changes視力變化
- ESerum digoxin level✓ 正解血清地高辛濃度
Digoxin 具負性變時作用，給藥前需聽一分鐘心尖脈（<60 bpm 需停藥）。低血鉀會增加藥物毒性，故需監測鉀濃度。血中藥物濃度過高（>2 ng/mL）有毒性風險。血壓非直接影響指標，視覺變化屬中毒症狀而非給藥前評估。
Digoxin has a negative chronotropic effect, so the apical pulse must be auscultated for one full minute before administration (the drug should be held if the rate is less than 60 bpm). Hypokalemia increases the risk of digoxin toxicity, so serum potassium must be monitored. Elevated serum digoxin levels (greater than 2 ng/mL) carry a risk of toxicity. Blood pressure is not a direct predictor of administration safety, and vision changes are a sign of toxicity rather than a routine pre-administration assessment.
台美皆嚴格要求聽心尖脈，但在電子病歷紀錄上，台灣常需護理師手動輸入數據，美國多由中央系統自動判斷。