— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予心衰竭病人毛地黃（digoxin）。給藥前測量心尖脈為 54 次/分，護理師應採取何項優先行動？
A nurse is administering a dose of digoxin to a patient with heart failure. Before administration, the nurse notes the apical heart rate is 54 bpm. Which action is the priority?
- AAdminister half the dose給予半劑量
- BRecheck the heart rate in 30 minutes30分鐘後重新測量心率
- CWithhold the dose and notify the provider✓ 正解暫停給藥並通知醫師
- DAdminister the medication as ordered依醫囑給予藥物
— Explanation · 中文詳解 —
毛地黃具有正性肌力與負性變時作用。對於成人，若心尖脈（apical pulse）低於 60 次/分，代表藥物可能已造成嚴重心搏過緩，此時必須暫停給藥並通知醫師，以預防藥物毒性或心臟傳導阻滯。護理師應評估病人有無毒性反應（如視覺異常、噁心、嘔吐），並檢視血鉀濃度。擅自調整劑量或僅延後觀察均會延誤處置，違反給藥安全原則。
Digoxin should be withheld when the apical heart rate is below 60 beats per minute to prevent severe bradycardia and potential toxicity. The nurse must notify the healthcare provider before administering the medication, as adjusting the dose independently is outside nursing scope.