— 藥理與非經腸給藥 · EASY · MCQ —
護理師正為一位心衰竭病人投予毛地黃（Digoxin）。投藥前護理師測量心尖脈，下列何種數據需暫停給藥？
A nurse is administering digoxin to a patient with heart failure. Before administration, the nurse assesses the apical pulse. Which finding requires the nurse to withhold the medication?
- AApical pulse of 98 beats per minute心尖脈搏 98 次/分
- BApical pulse of 52 beats per minute✓ 正解心尖脈搏 52 次/分
- CApical pulse of 72 beats per minute心尖脈搏 72 次/分
- DApical pulse of 88 beats per minute心尖脈搏 88 次/分
— Explanation · 中文詳解 —
Digoxin 具負性變時作用（Negative Chronotropic effect），會減慢心率。成人給藥標準為心率 <60 次/分時應暫停並通知醫師，以防引起嚴重的竇性心搏過緩或傳導阻滯。選項 C、D、A 皆在安全範圍內，可按醫囑繼續給藥。
Digoxin has a negative chronotropic effect that slows the heart rate, so the nurse must withhold the medication if the apical pulse is below 60 beats per minute to prevent severe bradycardia or heart block. The other pulse rates listed are within the safe range for administration.
✦ 台美臨床差異
美台臨床對於給藥前心率評估的標準一致，皆遵循藥物交互作用與毒性預防原則。