— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心衰竭病人毛地黃（Digoxin），評估心尖脈為每分鐘 54 下。下列哪項措施最為適當？
A nurse is administering a dose of digoxin to a patient with heart failure. Before administration, the nurse notes an apical pulse of 54 bpm. Which action is the most appropriate?
- AAdminister half the dose給予半劑量
- BAdminister the dose as ordered依醫囑給藥
- CReassess the apical pulse in 30 minutes30 分鐘後重新評估心尖脈
- DHold the dose and notify the healthcare provider✓ 正解暫停給藥並通知醫療提供者
— Explanation · 中文詳解 —
Digoxin 具有負性變時作用（減慢心跳）。給藥前，護理師必須評估心尖脈。成年人心率若低於 60 bpm，代表藥物影響過大，有導致嚴重竇性心搏過緩的風險，此時應暫停給藥並通知醫師。這是用藥安全的核心要求。護理師不可自行調整劑量，也不應忽視數值直接給藥。等待醫囑後，醫師可能會調整劑量或觀察病人有無其他心衰竭惡化徵兆。
Digoxin has a negative chronotropic effect, and an apical pulse below 60 bpm in adults indicates excessive slowing of the heart rate. The nurse must withhold the medication and notify the healthcare provider to prevent serious complications like heart block, as dose adjustments are outside the nurse's scope.