— 藥理與非經腸給藥 · HARD · SATA —
護理師準備給藥，下列哪些藥物應暫停給藥並通知醫師？（選所有適合的）
A nurse is preparing to administer several medications to a client. Which medication requires the nurse to hold the dose and notify the healthcare provider? (Select all that apply.)
- ADigoxin for a client with a pulse of 52 bpm✓ 正解脈搏 52 bpm 之病人的地高辛
- BLisinopril for a client with a potassium level of 5.8 mEq/L✓ 正解血鉀 5.8 mEq/L 之病人的 Lisinopril
- CMetoprolol for a client with a blood pressure of 118/76 mmHg血壓 118/76 mmHg 之病人的 Metoprolol
- DWarfarin for a client with an INR of 4.5✓ 正解INR 4.5 之病人的 Warfarin
- EFurosemide for a client with a blood pressure of 130/85 mmHg血壓 130/85 mmHg 之病人的 Furosemide
— Explanation · 中文詳解 —
臨床判斷給藥安全性：Digoxin 心跳 <60 bpm 應停藥；Lisinopril（ACEI）會保留鉀，高血鉀應停藥；Warfarin INR 4.5 超過治療目標（通常 2-3），有出血風險；Metoprolol 與 Furosemide 在此血壓數據下可正常給藥。
The nurse must hold digoxin for a pulse below 60 bpm due to toxicity risk, withhold lisinopril in hyperkalemia (potassium >5.0 mEq/L) because ACE inhibitors retain potassium, and hold warfarin if the INR exceeds the therapeutic range (typically 2-3) to prevent bleeding. Metoprolol and furosemide can be administered as the blood pressure is stable.
✦ 台美臨床差異
美國護理師依據醫院 policy 有更大的獨立判斷停藥權限，台灣護理師通常需向醫師確認後才正式暫停。