— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心衰竭病人毛地黃（digoxin）。給藥前測量心尖脈為每分鐘 52 下，護理師應採取何種行動？
A nurse is administering digoxin to a patient with heart failure. Before administering the medication, the nurse assesses the apical pulse. Which action should the nurse take if the apical pulse is 52 beats per minute?
- AAdminister the medication and document the pulse rate給藥並記錄脈率
- BAsk the patient to walk around to increase the heart rate請病人走動以增加心率
- CAdminister half of the prescribed dose給予處方劑量的一半
- 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 —
Digoxin 具負性變時作用（減慢心跳）。臨床常規要求成人心跳低於 60 bpm 需暫停給藥，以預防心搏過慢導致心輸出量不足。護理師應保留劑量並聯繫醫師評估藥物劑量調整，不可擅自減量或催促病人運動。
Digoxin slows the heart rate, so it should be withheld if the apical pulse is below 60 beats per minute in adults. Administering the drug during bradycardia can lead to severe cardiac complications. The nurse must notify the healthcare provider before administering the next dose.
✦ 台美臨床差異
美台臨床皆採 60 bpm 為給藥基準點，但台灣部分醫院習慣由醫師親自確認後才開立暫停給藥醫囑。