— 降低風險 · MEDIUM · MCQ —
護理師準備給予心衰竭病人毛地黃（Digoxin）。下列哪項評估結果需要暫停給藥？
A nurse is administering digoxin to a client with heart failure. Which assessment finding requires holding the dose?
- ABlood pressure of 120/80 mmHg血壓 120/80 mmHg
- BApical pulse of 52 beats per minute✓ 正解心尖脈搏 52 次/分
- CPotassium level of 4.0 mEq/L鉀離子濃度 4.0 mEq/L
- DWeight gain of 0.5 kg overnight一夜之間體重增加 0.5 kg
— Explanation · 中文詳解 —
Digoxin 具有正性肌力作用及負性變時作用（減慢心跳）。臨床給藥前，護理師必須測量心尖脈（Apical pulse）滿一分鐘。若成人心跳低於 60 次/分，則視為心動過緩（Bradycardia），此時給藥恐導致嚴重的心律不整，必須暫停並通知醫師。其他選項（血壓、血鉀、體重）雖與心衰竭管理相關，但心跳頻率是直接決定 Digoxin 給藥與否的關鍵指標。
Digoxin has a negative chronotropic effect, meaning it slows the heart rate. An apical pulse below 60 beats per minute indicates bradycardia, which is a sign of potential toxicity and a contraindication for administration. Holding the dose and notifying the provider is essential to prevent serious cardiac arrhythmias.