— 藥理與非經腸給藥 · EASY · MCQ —
護理師欲給予一位心衰竭病人地高辛 (digoxin)。下列哪項評估結果要求護理師暫停給藥？
A nurse is administering a dose of digoxin to a patient with heart failure. Which assessment finding requires the nurse to withhold the medication?
- APotassium level of 4.2 mEq/L鉀離子濃度為 4.2 mEq/L
- BApical pulse rate of 52 beats per minute✓ 正解心尖脈搏速率為每分鐘 52 次
- CBlood pressure of 110/70 mmHg血壓為 110/70 mmHg
- DPresence of 1+ pedal edema足背有 1+ 水腫
— Explanation · 中文詳解 —
Digoxin 具有強心且減慢心跳的藥理作用，成人若心跳每分鐘低於 60 下，應暫停給藥並通知醫師，以防嚴重心動過緩或傳導阻滯。血壓正常、鉀離子正常及輕微水腫均未達停藥標準，反而可能顯示病情正在改善中。
Digoxin should be withheld if the apical pulse is less than 60 beats per minute in adults, as the drug slows heart rate and could precipitate severe bradycardia or heart block. Normal potassium levels, blood pressure, and mild edema do not contraindicate administration.
✦ 台美臨床差異
台美臨床皆嚴格執行給藥前心率監測，惟美國電子病歷有自動警示系統。