護理師為心衰竭病人靜脈注射地高辛（Digoxin），若出現何種評估結果需暫停給藥？
A nurse is administering a dose of intravenous digoxin to a client with heart failure. Which assessment finding should lead the nurse to withhold the medication?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BPotassium level of 4.2 mEq/L鉀離子濃度 4.2 mEq/L
- CRespiratory rate of 18 breaths per minute呼吸頻率 18 次/分
- DApical heart rate of 52 beats per minute✓ 正解心尖脈搏 52 次/分
Digoxin 是一種強心藥物，具有負向變時作用（減慢心跳）與正向變力作用（增加心肌收縮力）。其治療窗狹窄，容易產生毒性。臨床指引規定，成年人給藥前若心尖脈搏小於 60 次/分，必須暫停給藥並回報醫師，因為過慢的心跳可能導致房室傳導阻滯或心輸出量不足。護理師應同時監測是否有毒性徵兆，如噁心、嘔吐、視覺異常或心律不整。
Digoxin is a cardiac glycoside with a negative chronotropic effect (slows heart rate) and a positive inotropic effect (increases myocardial contractility). It has a narrow therapeutic window and is prone to toxicity. Clinical guidelines specify that in adults, if the apical pulse is less than 60 beats per minute before administration, the dose must be held and the provider notified, because excessive bradycardia may cause atrioventricular block or inadequate cardiac output. The nurse should also monitor for signs of toxicity, such as nausea, vomiting, visual disturbances, or dysrhythmias.