— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予一位心衰竭病人 digoxin 0.25 mg。給藥前發現心尖脈搏為 54 次/分，護理師的首要行動為何？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Before administration, the nurse notes an apical pulse of 54 bpm. What is the priority nursing action?
- ARecheck the apical pulse in 30 minutes30 分鐘後重新測量心尖脈搏
- BWithhold the dose and notify the provider✓ 正解暫停給藥並通知醫師
- CObtain an ECG immediately立即取得心電圖
- DAdminister the medication as ordered依指示給予藥物
— Explanation · 中文詳解 —
Digoxin 具有負性頻率效應，成人心跳低於 60 次/分時應暫停給藥，以防心跳過慢導致心輸出量進一步下降。護理師應先暫停給藥並聯繫醫師評估是否調整劑量。重複測量或執行心電圖皆會延誤評估時機，直接給藥則會加重心搏過緩。
Digoxin has a negative chronotropic effect, and the dose should be withheld if the apical pulse is below 60 beats per minute to prevent worsening bradycardia and decreased cardiac output. The nurse must withhold the medication and notify the provider for further evaluation rather than delaying assessment or administering the drug.
✦ 台美臨床差異
台美臨床原則一致，皆要求心率低於 60 bpm 應暫停給藥並通知醫師。