— 藥理與非經腸給藥 · EASY · MCQ —
護理師準備給予一位心房顫動病人地高辛（Digoxin）。若出現下列哪項評估結果，護理師應暫停給藥？
A nurse is preparing to administer digoxin to a patient with atrial fibrillation. Which assessment finding requires the nurse to hold the medication?
- ABlood pressure 110/70 mmHg血壓 110/70 mmHg
- BPotassium level 3.2 mEq/L✓ 正解鉀離子濃度 3.2 mEq/L
- CRespiratory rate 16 breaths/min呼吸頻率 16 次/分
- DHeart rate 72 bpm心率 72 bpm
— Explanation · 中文詳解 —
地高辛（Digoxin）具有正性肌力與負性頻率作用，治療指數極窄。低血鉀（Hypokalemia）是地高辛中毒的最常見誘發因子，因為鉀離子與地高辛在心肌細胞上有競爭結合位點，血鉀過低會使地高辛結合力增強，進而誘發致命性心律不整。因此，給藥前必須確認電解質數值。其他選項（心跳、血壓、呼吸）雖需監測，但除非心跳低於安全閾值（通常為60 bpm），否則電解質不平衡是給藥前更具危險性的阻礙因素。
Hypokalemia significantly increases the risk of digoxin toxicity because low potassium levels enhance the drug's binding to cardiac cells, potentially leading to fatal arrhythmias. Therefore, the nurse must hold the medication and notify the provider if the potassium level is below the normal range.