— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師準備給予地高辛(Digoxin),哪項評估結果顯示應暫停給藥?
A nurse is administering a dose of digoxin. Which assessment indicates a need to hold the medication?
- ASerum potassium level of 4.2 mEq/L血清鉀濃度為 4.2 mEq/L
- BBlood pressure of 120/80 mmHg血壓為 120/80 mmHg
- CApical heart rate of 52 beats per minute✓ 正解心尖脈率為每分鐘 52 次
- DClient reports feeling energetic病人表示感覺精力充沛
— Explanation · 中文詳解 —
地高辛(Digoxin)具有正性肌力與負性心律作用,極易產生中毒。當心率過低(成人 < 60 bpm)時,繼續給藥可能導致嚴重的竇性心搏過緩(Sinus bradycardia)或心傳導阻滯。因此,給藥前測量心尖脈(Apical pulse)一分鐘是確保用藥安全的必要評估,若心率低於標準,必須暫停給藥並回報醫師。
Digoxin has a negative chronotropic effect, so the nurse must hold the medication if the apical heart rate is below 60 beats per minute to prevent severe bradycardia or heart block. Other options such as normal potassium levels or blood pressure do not indicate a need to withhold the dose.