— 藥理與非經腸給藥 · EASY · MCQ —
護理師欲給予心臟衰竭病人 Digoxin 0.25 mg。下列何種臨床表徵需要護理師暫停給藥？
A nurse is administering digoxin 0.25 mg to a client with heart failure. Which clinical finding requires the nurse to withhold the medication?
- AApical pulse of 52 beats per minute✓ 正解心尖脈搏 52 次/分
- BSerum potassium level of 4.2 mEq/L血清鉀濃度 4.2 mEq/L
- CBlood pressure of 110/70 mmHg血壓 110/70 mmHg
- DClient reports mild nausea客戶主訴輕微噁心
— Explanation · 中文詳解 —
Digoxin 具有負性心律作用。成人心跳低於每分鐘 60 下時，必須先暫停給藥並通知醫師，以防止嚴重的心動過緩。低血鉀會增加毛地黃毒性，但此處數值正常；噁心雖為毒性指標，但脈搏過慢是直接給藥前的安全界線。
Digoxin has a negative chronotropic effect. When the adult heart rate falls below 60 beats per minute, the medication must be held and the physician notified to prevent severe bradycardia. Hypokalemia increases digoxin toxicity, but in this case the value is normal; nausea is a toxicity indicator, but a slow pulse is the direct safety threshold before administration.
✦ 台美臨床差異
台美對於給藥前心跳標準一致，但台灣護理師常需確認醫囑是否有額外的給藥限制。