— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心臟衰竭病人地高辛（digoxin）。給藥前測量心尖脈為每分鐘 54 下，護理師最應採取什麼行動？
A nurse is administering a dose of digoxin to a patient with heart failure. Before administration, the nurse notes an apical pulse of 54 bpm. What is the most appropriate action?
- AAdminister the medication as ordered按醫囑給藥
- BAdminister half the dose給予半劑量
- CHold the medication and notify the provider✓ 正解暫停給藥並通知醫師
- DRetake the pulse in 30 minutes30分鐘後重新測量脈搏
— Explanation · 中文詳解 —
Digoxin 是一種強心劑，具有負性變時作用（Negative chronotropic effect），會降低心率。臨床規範中，成人若心尖脈（Apical pulse）低於 60 bpm，即可能發生毒性或嚴重的心搏過緩。因此，給藥前必須確認心率，若低於此數值，護理師應暫停給藥並通知醫師，以防止心臟抑制惡化。
Digoxin has a negative chronotropic effect that lowers the heart rate, and administration is contraindicated if the apical pulse is below 60 bpm due to the risk of severe bradycardia. Therefore, the nurse must hold the medication and notify the provider to prevent worsening cardiac suppression.