— 藥理與非經腸給藥 · MEDIUM · MCQ —
護理師為心衰竭病人靜脈注射地高辛（Digoxin），給藥前最應優先進行的評估為何？
A nurse is administering a dose of intravenous digoxin to a client with heart failure. Which assessment finding should the nurse prioritize prior to administration?
- ARespiratory rate呼吸頻率
- BApical heart rate✓ 正解心尖脈搏
- CBlood pressure血壓
- DSerum potassium level血清鉀濃度
— Explanation · 中文詳解 —
Digoxin 具負性變時作用（減慢心率）。臨床規定心尖脈若低於 60 次/分（成人）需暫停給藥，以防嚴重的心搏過緩。雖然鉀離子過低會增加 digoxin 毒性，但心跳頻率是每次給藥前最即時的指標，直接關係到心律失常的立即風險。
The nurse should prioritize assessing the apical heart rate because digoxin has a negative chronotropic effect and can cause bradycardia. Administration should be withheld if the heart rate is below 60 beats per minute to prevent serious arrhythmias, even though serum potassium levels also influence toxicity risk.
✦ 台美臨床差異
台美臨床均嚴格執行給藥前心尖脈監測，但美國護理師常需在電氣紀錄系統核對劑量限制。