— 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），聽診心尖脈發現每分鐘 52 下。此時的首要行動為何？
A nurse is administering a dose of digoxin to a patient with heart failure. Before administration, the nurse notes the client's apical pulse is 52 beats per minute. Which action is the priority?
- AAdminister the medication as scheduled依原定計畫給予藥物
- BAdminister half the prescribed dose給予處方劑量的一半
- CWithhold the dose and notify the healthcare provider✓ 正解暫停給藥並通知醫療提供者
- DReassess the pulse in 30 minutes30 分鐘後重新評估脈搏
— Explanation · 中文詳解 —
毛地黃（Digoxin）具有負性變時作用（Negative chronotropic effect），會減慢心率。成人給藥標準通常為心尖脈（Apical pulse）需大於 60 次/分。若心跳小於 60 次/分，給藥可能導致嚴重竇性心搏過緩。護理師應暫停給藥，並通知醫師評估是否調整劑量或檢查血清藥物濃度。
The priority action is to withhold the digoxin dose and notify the healthcare provider because the apical pulse of 52 beats per minute is below the typical safety threshold of 60 beats per minute. Digoxin has a negative chronotropic effect, and administering it at this heart rate could precipitate dangerous bradycardia.