— 藥理與非經腸給藥 · EASY · MCQ —
護理師正準備給予心衰竭病人 digoxin。出現下列何種評估結果時，應暫停給藥？
A nurse is administering digoxin to a patient with heart failure. Which assessment finding should lead the nurse to hold the medication?
- AApical pulse rate of 52 beats per minute✓ 正解心尖脈率每分鐘52次
- BBlood pressure of 110/70 mmHg血壓110/70 mmHg
- CPotassium level of 4.2 mEq/L鉀離子濃度4.2 mEq/L
- DPresence of pedal edema存在腳踝水腫
— Explanation · 中文詳解 —
Digoxin 具負性變時作用，若心跳過慢（成人心尖脈 < 60 bpm）會導致毒性或嚴重心動過緩。給藥前必須確認心跳。血鉀 4.2 在正常範圍（3.5-5.0），非停藥理由；血壓與水腫非停藥之直接指標。
Digoxin has a negative chronotropic effect, so the nurse must withhold the medication if the apical pulse is less than 60 beats per minute to prevent severe bradycardia or toxicity. While normal potassium levels and stable blood pressure are important, they do not directly contraindicate administration in the same immediate way as a low heart rate.
✦ 台美臨床差異
台美臨床對於洋地黃給藥前的評估均極為重視，皆以心尖脈 60 bpm 作為分界。