— 生理適應 · EASY · MCQ —
一位有心房顫動病史的病人被處方 Digoxin。護理師應指導病人回報何種可能代表藥物中毒的症狀？
A client with a history of atrial fibrillation is prescribed digoxin. The nurse should instruct the client to report which symptom that may indicate toxicity?
- ABradycardia✓ 正解心動過緩
- BWeight gain體重增加
- CIncreased energy精力增加
- DOccasional skipped beats偶爾漏跳
— Explanation · 中文詳解 —
Digoxin 的毒性徵象包括心跳變慢（bradycardia）、心律不整、噁心、嘔吐、視力模糊（看到黃綠色光暈）、疲勞。偶爾漏跳（skipped beats）可能是藥物療效，但顯著心跳變慢是中毒警訊。
Digoxin toxicity commonly presents with bradycardia due to its effect on slowing the heart rate and increasing vagal tone. Clients should be instructed to monitor their pulse and report any significant slowing, as this is a classic early warning sign of toxicity. While occasional skipped beats may occur, persistent bradycardia requires immediate medical attention to prevent serious arrhythmias.
✦ 台美臨床差異
美國病人教育常強調 Digoxin 的自我監測，特別是脈搏的測量；台灣亦然，但病人自行測量脈搏的習慣可能因文化和教育程度而異。