— 藥理與非經腸給藥 · EASY · MCQ —
護理師欲給予心衰竭病人 digoxin 0.25 mg。給藥前應優先評估下列哪項臨床指標？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Which clinical finding should the nurse prioritize before drug administration?
- ASerum potassium level from the previous day前一天的血清鉀濃度
- BBlood pressure reading in the supine position仰臥位時的血壓讀數
- CApical pulse rate for one full minute✓ 正解完整一分鐘的心尖脈率
- DPeripheral edema and daily weight周邊水腫與每日體重
— Explanation · 中文詳解 —
Digoxin 具有負性頻率作用，若心跳過慢（成人 <60 bpm）會導致嚴重心搏過緩。因此，給藥前必須確實執行一分鐘心尖脈聽診。若心跳過低，護理師應先暫停給藥並通知醫師，以避免毒性反應加劇或心輸出量下降。
Digoxin has a negative chronotropic effect; if the heart rate is too slow (adult <60 bpm), it can cause severe bradycardia. Before administration, the nurse must auscultate the apical pulse for a full minute. If the rate is too low, the nurse holds the drug and notifies the provider to prevent toxicity or reduced cardiac output.
✦ 台美臨床差異
台美臨床皆將心尖脈作為給藥標準，但台灣護理紀錄對於心尖脈的數值核對標準更加嚴格。