— 藥理與非經腸給藥 · HARD · SATA —
護理師準備給予心衰竭病人地高辛（Digoxin）。給藥前應執行哪些措施？（選所有適合的）
A nurse is preparing to administer digoxin to a client with heart failure. Which actions are required before administration? (Select all that apply.)
- AAssess the apical pulse for one full minute✓ 正解評估心尖脈搏至少一整分鐘
- BCheck serum potassium levels✓ 正解檢查血清鉀離子濃度
- CMeasure the radial pulse測量橈動脈脈搏
- DVerify the most recent digoxin level✓ 正解確認最近的地高辛濃度
- ECheck the BP檢查血壓
— Explanation · 中文詳解 —
給予地高辛前必須確認心搏速率，心尖脈測量一分鐘最準確，若 <60 bpm 需暫停給藥。此外，低血鉀會增加毛地黃毒性，故需檢查血鉀。地高辛治療範圍狹窄，定期確認血中濃度以防中毒至關重要。橈動脈脈搏無法反映心臟實際收縮情況，血壓與此藥毒性無直接關聯。
Before giving digoxin, verify the heart rate — apical pulse over a full minute is most accurate; hold the dose if < 60 bpm. Low potassium increases digoxin toxicity, so check serum K+. Digoxin has a narrow therapeutic index, so verify the latest digoxin level. Radial pulse is less accurate for assessing cardiac contractions, and blood pressure is not directly related to digoxin toxicity.
✦ 台美臨床差異
兩地均高度重視地高辛給藥前的「心尖脈」評估，這是護理技術考核的經典項目。