— 藥理與非經腸給藥 · EASY · MCQ —
病人每日服用地高辛（Digoxin）0.25 mg。下列哪項評估結果要求護理師暫緩給藥並通知醫師？
A client is prescribed digoxin 0.25 mg daily. Which assessment finding would require the nurse to hold the dose and notify the physician?
- ATemperature 37.2°C (99°F)體溫 37.2°C (99°F)
- BRespiratory rate 16 breaths/min呼吸頻率 16 次/分
- CApical heart rate 52 beats/min✓ 正解心尖脈搏 52 次/分
- DBlood pressure 110/70 mmHg血壓 110/70 mmHg
— Explanation · 中文詳解 —
地高辛（Digoxin）是一種常用的強心劑，主要用於治療心臟衰竭和心房顫動。其主要藥理作用包括增加心肌收縮力（正性肌力作用）和減慢心率（負性變時作用）。由於地高辛的治療窗狹窄，即有效劑量與中毒劑量非常接近，因此在給藥前必須進行仔細的評估，尤其是心率。護理師在給藥前測量心尖脈是確保病人安全，避免心率過低引發危險的關鍵步驟。
Digoxin has a narrow therapeutic index and exerts a negative chronotropic effect, slowing the heart rate. An apical pulse below 60 beats per minute in an adult indicates potential toxicity or excessive drug effect, requiring the nurse to hold the dose and notify the provider to prevent bradycardia or heart block.