— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予心臟衰竭病人毛地黃（Digoxin）。下列哪項評估結果需要暫停給藥？
A nurse is preparing to administer digoxin to a client with heart failure. Which assessment data requires withholding the medication?
- AApical heart rate of 52 beats per minute✓ 正解心尖脈搏為每分鐘 52 次
- BClient reports mild nausea個案主訴輕微噁心
- CBlood pressure of 110/70 mmHg血壓為 110/70 mmHg
- DPotassium level of 4.2 mEq/L血鉀濃度為 4.2 mEq/L
— Explanation · 中文詳解 —
毛地黃（Digoxin）具有正性肌力作用（增加心肌收縮力）與負性變時作用（減慢心跳）。給藥前必須測量心尖脈（Apical pulse）滿一分鐘，若成人心跳小於 60 次/分，則須暫停給藥並通知醫師，以防引發嚴重心跳過慢（Bradycardia）或傳導阻滯。此外，低血鉀會增加毛地黃的毒性作用，因此電解質監測也至關重要。
Digoxin has a negative chronotropic effect that slows the heart rate, making bradycardia a primary contraindication for administration. An apical heart rate below 60 beats per minute in adults indicates potential toxicity or excessive slowing, requiring the nurse to withhold the medication and notify the provider.