— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備對心衰竭病人給予毛地黃（Digoxin），給藥前最關鍵的評估項目為何？
A nurse is administering a dose of digoxin to a patient with heart failure. Before giving the medication, which assessment is most critical?
- APeripheral edema周邊水腫
- BRespiratory rate呼吸頻率
- CBlood pressure血壓
- DApical heart rate for one full minute✓ 正解測量完整一分鐘的心尖脈搏
— Explanation · 中文詳解 —
Digoxin 具有強心與負性傳導作用，若心跳過慢（成人 <60 bpm）會導致嚴重心跳過緩與毒性反應。因此，給藥前必須聽診心尖脈整整一分鐘以確保心跳頻率在安全範圍內，這比血壓或水腫監測更為直接相關。
Digoxin has a negative chronotropic effect, so the nurse must assess the apical heart rate for a full minute before administration to ensure it is not below 60 beats per minute. Withholding the medication if bradycardia is present prevents toxicity and severe cardiac complications.
✦ 台美臨床差異
台美臨床均嚴格執行給藥前心跳評估，台灣護理師常須於給藥紀錄卡蓋章確認。