— 藥理與非經腸給藥 · EASY · MCQ —
護理師正準備給予心衰竭病人 digoxin 0.25 mg。下列何種臨床表徵應促使護理師暫停給藥？
A nurse is administering digoxin 0.25 mg orally to a client with heart failure. Which clinical finding should prompt the nurse to withhold the medication?
- APotassium level of 4.2 mEq/L血鉀濃度 4.2 mEq/L
- BBlood pressure of 110/70 mmHg血壓 110/70 mmHg
- CRespiratory rate of 18 breaths per minute呼吸頻率 18 次/分
- DApical pulse rate of 52 beats per minute✓ 正解心尖脈搏 52 次/分
— Explanation · 中文詳解 —
Digoxin 具有強心與負性心率作用，成人心率低於 60 次/分時，給藥會加重房室傳導阻滯或心動過緩風險，故應暫停並通知醫師。鉀離子正常（4.2 mEq/L），未增加毛地黃毒性風險。血壓與呼吸數據均在安全範圍，不影響該藥物使用。
Digoxin has a negative chronotropic effect, so the nurse must withhold the medication if the apical pulse is less than 60 beats per minute to avoid exacerbating bradycardia or heart block. Normal potassium levels, blood pressure, and respiratory rates do not contraindicate digoxin administration. Withholding the dose and notifying the provider is essential when signs of potential toxicity, such as bradycardia, are present.
✦ 台美臨床差異
美台臨床皆嚴格規定給藥前必須先測量心跳，但美國護理資訊系統常設定自動警示。