護理師準備對心衰竭病人給予地高辛（Digoxin），應採取哪些行動？（選所有適合的）
A nurse is preparing to administer digoxin to a client with heart failure. What actions should the nurse take? (Select all that apply.)
- ACount the apical pulse for one full minute✓ 正解完整計量心尖脈一分钟
- BWithhold the dose if the pulse is less than 60 bpm✓ 正解若脈搏低於60 bpm則暫停給藥
- CMonitor for visual disturbances✓ 正解監測是否有視覺障礙
- DAdminister with a large meal to prevent GI upset隨大餐服用以預防胃腸不適
- ECheck serum potassium levels✓ 正解檢查血清鉀濃度
Digoxin 具負性變時作用。給藥前必須聽診心尖脈一分鐘，若 <60 bpm 需停藥。低血鉀會增加中毒機率，故需監測鉀濃度。視力改變（如黃視、綠視）為中毒早期症狀。D 選項錯誤，應避免與高纖食物同時服用以免影響吸收。
Digoxin has a negative chronotropic effect. Before administration, the apical pulse must be auscultated for one full minute, and the dose withheld if the pulse is <60 bpm. Hypokalemia increases the risk of toxicity, so potassium levels must be monitored. Visual changes (such as yellow or green vision) are early signs of toxicity. Option D is incorrect because the medication should not be administered with high-fiber foods, as this would decrease absorption.
台灣醫囑通常已設定明確的心跳下限，護理師需嚴格執行；美國護理師對毒性徵兆的判斷自主性較高。