— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心衰竭病人地高辛（Digoxin），哪項評估結果需要暫停給藥？
A nurse is preparing to administer digoxin to a client with heart failure. Which assessment finding requires the nurse to withhold the medication?
- ABlood pressure 110/70 mmHg血壓 110/70 mmHg
- BClient reports mild nausea個案主訴輕微噁心
- CPotassium level 4.2 mEq/L血鉀濃度 4.2 mEq/L
- DApical pulse 52 beats per minute✓ 正解心尖脈搏 52 次/分
— Explanation · 中文詳解 —
Digoxin 具有負性頻率作用，若心跳過慢（成人 <60 bpm）會導致嚴重的心律失常。A 為正常範圍；C 為正常血壓；D 輕微噁心雖為毒性潛在徵兆，但心搏過緩是明確的給藥禁忌指標。必須先暫停並報告醫師評估心電圖。
Digoxin has a negative chronotropic effect, and when the heart rate is too slow (<60 bpm in adults), administration may cause severe arrhythmias. Option C is within the normal range; option A is a normal blood pressure; option B, mild nausea, is a potential sign of toxicity but bradycardia is the more clearly defined contraindication. The medication must be held and the provider notified to evaluate the EKG.
✦ 台美臨床差異
兩地均嚴格執行給藥前測量心跳；台灣護理師常須於給藥紀錄單簽名確認心跳數值。