— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予病人毛地黃（Digoxin）。下列哪項評估發現需要先暫停給藥？
A nurse is administering a dose of digoxin. Which assessment finding would require the nurse to withhold the medication?
- ABlood pressure of 130/85 mmHg血壓 130/85 mmHg
- BApical heart rate of 52 beats per minute✓ 正解心尖心率 52 次/分
- CPotassium level of 4.2 mEq/L血鉀濃度 4.2 mEq/L
- DClient reports mild nausea病人主訴輕微噁心
— Explanation · 中文詳解 —
Digoxin（毛地黃）具有正性肌力作用（增加收縮力）與負性變時作用（減慢心跳）。其治療範圍狹窄，極易發生中毒。臨床常規規定，成人若心尖脈低於 60 bpm，必須暫停給藥並諮詢醫師，因為進一步給藥可能導致嚴重的心動過緩（bradycardia）甚至房室傳導阻滯。護理師給藥前務必聽診心尖脈整整一分鐘以確保心率在安全範圍內。
Digoxin should be withheld if the apical heart rate is less than 60 beats per minute in adults, as the medication has a negative chronotropic effect that can exacerbate bradycardia. Since digoxin has a narrow therapeutic index, administering it when the heart rate is already low increases the risk of severe cardiac conduction disturbances and toxicity.