— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師準備給予心房顫動病人地高辛（Digoxin）。哪些發現需要護理師暫停給藥？（選所有適合的）
A nurse is administering a dose of digoxin to a patient with atrial fibrillation. Which findings require the nurse to withhold the medication? (Select all that apply.)
- AApical pulse 52 bpm✓ 正解心尖脈搏 52 次/分
- BPotassium level 3.2 mEq/L✓ 正解鉀離子濃度 3.2 mEq/L
- CPatient reports seeing yellow halos around lights✓ 正解病人主訴看到燈光周圍有黃色光暈
- DBlood pressure 130/80 mmHg血壓 130/80 mmHg
- ESerum digoxin level 2.5 ng/mL✓ 正解血清地高辛濃度 2.5 ng/mL
— Explanation · 中文詳解 —
地高辛毒性反應包括：心搏過慢（<60 bpm）、低血鉀（增加毒性敏感度）、視覺異常（黃視症）、以及藥物濃度過高（正常值約 0.5-2.0 ng/mL）。血壓 130/80 mmHg 為正常範圍，無需停藥。護理師需結合生理檢查、血清濃度與病人主觀症狀綜合判斷。
Digoxin should be held for: bradycardia (apical pulse <60 bpm); hypokalemia (which potentiates toxicity); visual disturbances such as yellow halos (a classic sign of toxicity); and serum digoxin levels above the therapeutic range of 0.5-2.0 ng/mL. A blood pressure of 130/80 mmHg is normal and not a reason to hold the drug.
✦ 台美臨床差異
美國護理師對地高辛給藥前的評估較依賴 protocol，台灣護理師則更強調醫囑中是否明確設定脈搏下限值。