— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師準備發藥。下列哪些病人的生理數值需要護理師暫停給藥？（選所有適合的）
A nurse is preparing to administer several medications. Which client findings require the nurse to hold the medication? (Select all that apply.)
- ADigoxin for a client with a pulse of 52 beats/min✓ 正解脈搏為 52 次/分的病人使用 Digoxin
- BLisinopril for a client with a blood pressure of 110/70 mmHg血壓為 110/70 mmHg 的病人使用 Lisinopril
- CMetoprolol for a client with a blood pressure of 90/60 mmHg✓ 正解血壓為 90/60 mmHg 的病人使用 Metoprolol
- DWarfarin for a client with an INR of 4.5✓ 正解INR 為 4.5 的病人使用 Warfarin
- EFurosemide for a client with a serum potassium of 3.0 mEq/L✓ 正解血清鉀為 3.0 mEq/L 的病人使用 Furosemide
— Explanation · 中文詳解 —
Digoxin 會減慢心跳，脈搏 <60 應停藥。Beta-blocker（Metoprolol）低血壓（收縮壓 <100）需審慎評估。INR 4.5 超過治療範圍，出血風險高，需諮詢醫師。低血鉀（<3.5）時使用利尿劑會加劇低鉀導致心律不整。B 選項 BP 110/70 尚屬穩定範圍，通常不需停藥。
Hold digoxin when pulse is <60. Beta-blockers like metoprolol should be held with systolic BP <100. An INR of 4.5 exceeds the therapeutic range and increases bleeding risk, so warfarin should be held and the provider consulted. Hypokalemia (<3.5) precludes loop diuretic administration due to dysrhythmia risk. B (BP 110/70) is acceptable for ACE inhibitor administration.
✦ 台美臨床差異
美台臨床對於給藥前的數據臨界值（cut-off）規範大致相同，但美國多依循各醫院電子病歷系統的警示功能執行。