— 藥理與非經腸給藥 · EASY · MCQ —
護理師為一位心衰竭病人靜脈注射毛地黃（Digoxin），下列哪項評估結果需要暫停給藥？
A nurse is administering a dose of intravenous digoxin to a client with heart failure. Which assessment finding requires the nurse to hold the medication?
- ABlood pressure of 110/70 mmHg血壓 110/70 mmHg
- BSerum potassium level of 4.2 mEq/L血清鉀濃度 4.2 mEq/L
- CApical heart rate of 52 beats per minute✓ 正解心尖脈搏 52 次/分鐘
- DClient report of mild nausea病人報告輕微噁心
— Explanation · 中文詳解 —
毛地黃（Digoxin）具有正性肌力與負性變時作用。心搏過緩（Bradycardia）是其中毒的早期警訊。成人給藥標準為心率低於 60 bpm 應暫停給藥並通知醫師。噁心、嘔吐、視力模糊等為中毒常見症狀，但心跳監測是給藥前最直接的安全評估。血鉀濃度與毛地黃中毒密切相關，低血鉀會增加中毒毒性，4.2 mEq/L 屬正常範圍。
The nurse must hold digoxin if the apical heart rate is below 60 beats per minute because the medication has negative chronotropic effects and bradycardia is a sign of potential toxicity. While mild nausea and normal potassium levels require monitoring, a heart rate of 52 bpm is an immediate safety concern that necessitates withholding the dose and notifying the provider.