— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備對心臟衰竭病人給予毛地黃（Digoxin），下列哪項評估結果需要暫停給藥？
A nurse is administering a dose of digoxin to a client with heart failure. Which assessment finding requires the nurse to hold the medication?
- AClient reports mild nausea個案報告輕微噁心
- BSerum potassium level of 4.2 mEq/L血清鉀濃度為 4.2 mEq/L
- CBlood pressure of 110/70 mmHg血壓為 110/70 mmHg
- DApical pulse rate of 52 beats per minute✓ 正解心尖脈搏率為每分鐘 52 次
— Explanation · 中文詳解 —
毛地黃具有負性心率作用（Negative Chronotropic Effect），給藥前必須測量心尖脈一分鐘。若成人心率低於 60 次/分，則視為毛地黃中毒指標之一或藥物效果過強，護理師應先暫停給藥並諮詢醫師，避免引發致命性心律不整。
Digoxin has a negative chronotropic effect, so the nurse must hold the medication if the adult apical pulse is below 60 beats per minute. This precaution prevents potential toxicity and life-threatening arrhythmias associated with excessive heart rate slowing.
✦ 台美臨床差異
美台對於心尖脈測量標準一致，但在電子病歷中，許多醫院會設定自動提示系統來輔助護理師決策。