— 藥理與非經腸給藥 · EASY · MCQ —
護理師正準備為心衰竭病人給予毛地黃（Digoxin），聽診心尖脈搏為 56 次/分。護理師應採取何項優先措施？
A nurse is administering a dose of digoxin to a patient with heart failure. Before administration, the nurse notes the client's apical heart rate is 56 bpm. What is the nurse's priority action?
- ARecheck the heart rate in 30 minutes30分鐘後重新檢查心率
- BWithhold the medication and notify the healthcare provider✓ 正解暫停給藥並通知醫療提供者
- CAdminister half the dose給予半劑量
- DAdminister the medication as scheduled按預定時間給藥
— Explanation · 中文詳解 —
Digoxin 具負性變時作用，成人心尖脈低於 60 bpm 需先停藥，因其中毒機轉與低心率密切相關。若直接給藥可能導致嚴重心搏過緩或致命心律不整。醫療人員應先暫停給藥，並聯繫醫師評估是否調整劑量或檢查血清濃度。
Digoxin can cause bradycardia, and an apical heart rate below 60 bpm indicates potential toxicity. The nurse should withhold the medication to prevent further slowing of the heart rate. The healthcare provider must be notified immediately to assess the client and determine if the dose needs adjustment.
✦ 台美臨床差異
美台臨床對於 Digoxin 給藥門檻均嚴格遵守 <60 bpm 停藥規定，但台灣護理紀錄對於扣藥原因的說明需更詳實。