— 生理適應 · MEDIUM · MCQ —
護理師正在照護一位有心臟衰竭且服用 Digoxin 的病人。哪項發現需要護理師暫停用藥並通知開藥醫師？
A nurse is caring for a client with a history of heart failure who is prescribed digoxin. Which finding requires the nurse to hold the medication and notify the prescriber?
- AJugular venous distention (JVD)頸靜脈怒張 (JVD)
- BClient reports anorexia and nausea✓ 正解病人主訴食慾不振和噁心
- CBlood pressure of 120/80 mmHg血壓 120/80 mmHg
- DHeart rate of 70 bpm心率 70 bpm
— Explanation · 中文詳解 —
厭食（anorexia）和噁心（nausea）是 Digoxin 中毒的早期症狀之一，尤其在伴隨心搏過緩時更需警惕。Digoxin 的治療範圍狹窄，中毒時可能導致心律不整。心率 70 bpm 正常；血壓正常；JVD 雖與心衰竭有關，但與 Digoxin 中毒的關聯性不如厭食噁心。
Anorexia and nausea are early signs of digoxin toxicity, which has a narrow therapeutic index and can lead to dangerous arrhythmias. The nurse should withhold the medication and notify the provider, as these symptoms indicate potential overdose, unlike stable vital signs or signs of heart failure.
✦ 台美臨床差異
美國的藥師會定期審核病人的藥物清單，識別潛在藥物中毒風險；台灣的護理師在給藥前也會嚴格執行 IV (Indication, Dose, Drug, Route, Time) 檢查，並注意中毒徵兆。