護理師正準備為心衰竭病人給予地高辛（Digoxin）。下列哪項評估結果顯示護理師應先暫停給藥？
A nurse is administering digoxin to a patient with heart failure. Which assessment finding requires the nurse to hold the medication?
- ARespiratory rate of 18 breaths per minute呼吸速率為每分鐘18次
- BBlood pressure of 110/70 mmHg血壓為110/70 mmHg
- CSerum potassium level of 4.2 mEq/L血清鉀濃度為4.2 mEq/L
- DApical pulse rate of 52 beats per minute✓ 正解心尖脈搏速率為每分鐘52次
地高辛（Digoxin）是一種強心苷類藥物，具有正性肌力作用（增加心肌收縮力）與負性變時作用（減慢心跳）。給藥前必須評估心率，因為其可能導致嚴重的心跳過緩（bradycardia）或傳導阻滯。若成人心尖脈低於 60 次/分，給藥可能使心跳進一步惡化，故必須暫停並通知醫師。這是臨床安全給藥的標準流程，旨在預防藥物毒性與心律不整。
The most effective long-term conflict resolution strategy is collaboration, which involves meeting with both staff members to identify underlying issues and seek a win-win solution. This approach addresses the root causes of the dispute rather than ignoring it or forcing a compromise that may leave both parties dissatisfied. Taking sides or avoiding the conflict undermines professionalism and team cohesion.
美國臨床對於給藥前心跳評估標準極為嚴格，RN 若發現心跳 < 60 bpm 必須直接 Hold 並報告，無需等待醫師指示。台灣部分單位可能因醫囑不同而有差異，但在 NCLEX 考試中，請一律遵循 60 bpm 的標準。