— 藥理與非經腸給藥 · EASY · MCQ —
護理師即將給予心衰竭病人 digoxin 0.25 mg。給藥前最重要的評估為何？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Before giving the medication, which assessment is priority?
- ABlood pressure血壓
- BRespiratory rate呼吸速率
- CSerum potassium level血清鉀濃度
- DApical heart rate✓ 正解心尖脈搏
— Explanation · 中文詳解 —
Digoxin 是一種強心劑，具有正性肌力與負性變時作用（減慢房室結傳導）。給藥前最重要的護理評估是測量心尖脈（Apical pulse）滿一分鐘。若成年人心率低於 60 bpm，則應暫停給藥並通知醫師，以防藥物導致嚴重的竇性心搏過緩（Bradycardia）或致命性心律不整。這是用藥安全中的關鍵步驟，不可忽略。
Digoxin exerts a negative chronotropic effect by slowing conduction through the atrioventricular node, making it essential to assess the apical pulse for one full minute before administration. If the adult heart rate is below 60 beats per minute, the nurse should withhold the medication and notify the provider to prevent severe bradycardia or toxicity.