— 藥理與非經腸給藥 · EASY · MCQ —
護理師正準備給予心臟衰竭病人心臟苷類藥物（digoxin）。下列何種評估發現需要暫停給藥？
A nurse is administering digoxin to a patient with heart failure. Which assessment finding requires holding the medication?
- APotassium level of 4.0 mEq/L鉀離子濃度為 4.0 mEq/L
- BBlood pressure of 110/70 mmHg血壓為 110/70 mmHg
- CApical pulse rate of 54 beats/min✓ 正解心尖脈搏速率為 54 次/分
- DRespiratory rate of 18 breaths/min呼吸速率為 18 次/分
— Explanation · 中文詳解 —
Digoxin 具有正性肌力作用（增強心肌收縮力）與負性變時作用（減慢心跳）。成人給藥的臨床安全準則為心尖脈（Apical pulse）需大於 60 次/分。若心跳過慢，給藥可能導致嚴重的竇性心搏過緩（Sinus bradycardia）或心律不整，因此護理師必須在給藥前進行完整一分鐘的心尖脈聽診。
Digoxin exerts a negative chronotropic effect, slowing the heart rate to improve cardiac efficiency in heart failure. The medication should be withheld if the apical pulse falls below 60 beats per minute to prevent severe bradycardia or toxicity. Normal potassium levels, blood pressure, and respiratory rates do not contraindicate administration.