— 藥理與非經腸給藥 · MEDIUM · SATA —
護理師準備給予心衰竭病人毛地黃（Digoxin）。下列哪些是給藥前的優先查核重點？（選所有適合的）
A nurse is preparing to administer digoxin to a client with heart failure. Which findings are priorities to check? (Select all that apply.)
- AApical pulse rate✓ 正解心尖脈搏速率
- BSerum potassium level✓ 正解血清鉀濃度
- CSerum digoxin level✓ 正解血清毛地黃濃度
- DBlood glucose level血糖濃度
- ERespiratory rate呼吸速率
— Explanation · 中文詳解 —
毛地黃具有負性變時作用（減慢心跳）且毒性與血鉀濃度相關（低血鉀易引發毒性）。給藥前需確保心跳 >60 bpm，電解質（尤其是鉀）在正常範圍內，並監測藥物血中濃度以預防中毒。血糖與呼吸速率非此藥物之重點監測項目。
Digoxin has a negative chronotropic effect, so bradycardia indicates potential toxicity, making apical pulse assessment a priority. Hypokalemia increases cardiac sensitivity to digoxin, raising the risk of toxicity, thus serum potassium must be monitored. Additionally, checking serum digoxin levels ensures the concentration remains within the therapeutic range to prevent adverse effects.
✦ 台美臨床差異
美國護理師對 Digoxin 給藥標準流程執行非常嚴謹，台灣電子病歷系統通常會自動擋下心跳過慢的醫囑。