— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心臟衰竭病人 0.25 mg 地高辛。給藥前發現心尖脈搏為 52 次/分。護理師首要採取什麼行動？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Before administration, the nurse notes an apical pulse of 52 bpm. What is the nurse's priority action?
- ARetake the pulse in 15 minutes to see if it improves15分鐘後重新測量脈搏，以觀察是否有改善
- BAdminister the dose with food to prevent gastric irritation隨餐給藥以預防胃腸道刺激
- CAdminister the medication and monitor the patient for 30 minutes給予藥物並監測病人30分鐘
- DWithhold the medication and notify the healthcare provider✓ 正解暫停給藥並通知醫療提供者
— Explanation · 中文詳解 —
地高辛（Digoxin）具有正性肌力與負性心律作用，給藥前必須確認心尖脈搏（Apical pulse）。成人給藥的標準為心率需大於 60 次/分。若心率過慢（小於 60 bpm），給藥會加重房室傳導阻滯或導致嚴重的心搏過緩。此時護理師應暫停給藥並聯繫醫師進行評估，這是預防藥物中毒與致命性心律不整的最重要安全措施。
Digoxin has negative chronotropic effects and can cause bradycardia; therefore, the apical pulse must be assessed before administration. In adults, the dose should be withheld if the heart rate is below 60 beats per minute to prevent toxicity and severe bradycardia. The nurse should contact the healthcare provider for further evaluation rather than administering the medication.