— 藥理與非經腸給藥 · EASY · MCQ —
病人處方中含有地高辛（Digoxin）。哪項評估結果應使護理師暫停給藥？
A nurse is caring for a client who is prescribed digoxin. Which assessment finding should lead the nurse to withhold the medication?
- AApical pulse 52 bpm✓ 正解心尖脈搏 52 次/分
- BPotassium level 4.2 mEq/L鉀離子濃度 4.2 mEq/L
- CBlood pressure 110/70 mmHg血壓 110/70 mmHg
- DDigoxin level 1.2 ng/mL地高辛濃度 1.2 ng/mL
— Explanation · 中文詳解 —
地高辛（Digoxin）具有正性肌力與負性變時作用（減慢心率）。臨床上若成人心跳小於 60 次/分，給藥可能導致嚴重的心搏過緩（Bradycardia），進而影響心輸出量。護理師給藥前必須確實測量心尖脈（Apical pulse）滿一分鐘。若數值偏低，應暫停給藥並通知醫師。其他選項如鉀離子與藥物濃度皆在安全範圍內，無需停藥。
The nurse should withhold digoxin if the apical pulse is less than 60 beats per minute because the medication has a negative chronotropic effect that can cause severe bradycardia. Digoxin increases myocardial contractility while slowing the heart rate, so a low pulse indicates a risk of further cardiac depression. Other parameters like potassium levels and digoxin concentration are within safe therapeutic ranges.