— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心臟衰竭病人 Digoxin 0.25 mg。給藥前，護理師最需要優先評估下列何者？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Before administration, which assessment finding is most important for the nurse to evaluate?
- ARespiratory rate呼吸頻率
- BApical pulse rate✓ 正解心尖脈搏速率
- CBlood pressure血壓
- DSerum potassium level血清鉀濃度
— Explanation · 中文詳解 —
Digoxin 具負性變時作用（減慢心跳）。給藥前必須聽診心尖脈（Apical pulse）滿一分鐘，若成人小於 60 次/分則需暫停給藥，以防嚴重的心搏過緩。雖然鉀離子過低會增加毒性風險，但脈搏是給藥前最直接的安全性判斷標準。
Digoxin has a negative chronotropic effect. Before administration, the nurse must auscultate the apical pulse for a full minute and hold the drug for adults with a pulse below 60/min to prevent severe bradycardia. While low potassium increases toxicity risk, pulse assessment is the most direct pre-administration safety check.
✦ 台美臨床差異
台美臨床皆重視聽心尖脈，但美國電子病歷常設自動警示，台灣護理師多依據給藥紀錄單手動確認。