— 降低風險 · MEDIUM · MCQ —
護理師準備為心衰竭病人給予地高辛（Digoxin）。給藥前的優先措施為何？
A nurse is preparing to administer digoxin to a client with heart failure. Which action is the priority before administering the medication?
- ACheck the client's blood pressure檢查病人的血壓
- BAssess the client's potassium level評估病人的鉀離子濃度
- CCheck the apical pulse for one full minute✓ 正解完整聽診心尖脈搏一分鐘
- DVerify the client's weight確認病人的體重
— Explanation · 中文詳解 —
Digoxin 具有負性頻率作用（降低心跳），若心跳過慢（成人通常 <60 bpm）給藥會導致嚴重心搏過緩。因此，給藥前必須聽診心尖脈一分鐘以確保心律穩定。B 選項雖也正確（低血鉀會增加 Digoxin 毒性），但臨床常規給藥前第一順序是評估心跳。
Digoxin has a negative chronotropic effect and can cause severe bradycardia if administered when the heart rate is already low. Checking the apical pulse for one full minute is the priority assessment to identify bradycardia (typically <60 bpm) and prevent digoxin toxicity, whereas assessing potassium levels, while important, is secondary to this immediate safety check.
✦ 台美臨床差異
在兩國，給藥前評估心跳皆為核心安全指引，護理師常需記錄在給藥單上。