digoxin – n. 地高辛
heart defects – 心脏缺陷
margin of safety – 安全域，安全边际
impending – n. 即将来临的
phosphodiesterase – n. 磷酸二酯酶
bioavailability – n. 生物利用率
“RN-ISPN考试复习要点提示”
帮助您尽快理清复习思路，准确抓住复习重点，是ISPN/RN考试复习的一大利器！
————RN/ISPN Review ————
Cardiotonic Agents Across the Lifespan
不同年龄组的强心药使用
Children 儿童
Digoxin is used widely in children with heart defects and related cardiac problems. The margin of safety for the dosage drug is very small with children. The dosage needs to be very carefully calculated and should be double-checked by another nurse before administration.
地高辛广泛用于心脏缺陷及相关心脏问题儿童。儿童的剂量安全边际极小。剂量需要非常仔细地计算，并在给药前与另一名护士核对检查。
Children should be monitored closely for any sign of impending digitalis toxicity and should have serum digoxin levels monitored.
应密切监测儿童有无即将出现地高辛毒性的体征，监测血清地高辛水平。
The phosphodiesterase inhibitors and HCN blockers are not recommended for use in children.
磷酸二酯酶抑制剂和HCN阻滞剂不推荐用于儿童。
Adults 成人
Adults receiving any of these drugs need to be instructed as to what adverse reactions to report immediately. They should learn to take their own pulse and should be encouraged to keep track of rate and regularity on a calendar. They may be asked to weigh themselves in the same clothing and at the same time of the day to monitor for fluid retention. Any changes in diet, GI activity, or medications should be reported to the health care provider because of the potential for altering serum levels and causing toxic reactions or ineffective dosing.
Patients should also be advised against switching between brands of digoxin because there have been reports of different bioavailabilities, leading to toxic reactions.
还应忠告患者不要更换地高辛品牌，因为有报道显示，不同品牌有不同的生物利用度，会导致毒性反应。
The safety for the use of these drugs during pregnancy has not been established. They should not be used in pregnancy unless the benefit to the mother clearly outweighs the potential risk to the fetus. The drugs do enter breast milk, but they have not been associated with any adverse effects in the neonate. Caution should be exercised, however, if one of these drugs is needed during lactation.
Older adults frequently are prescribed one of these drugs. They, like children at the other end of the life spectrum, are more susceptible to the toxic effects of the drugs and are more likely to have underlying conditions that could interfere with their metabolism and excretion.
老人经常被开其中一种药物的处方，老人与生命另一端的儿童一样，更易受到药物毒性效应的影响，更可能得可能影响其代谢和排泄的基础疾病。
Renal impairment can lead to accumulation of digoxin in the body. If renal dysfunction is present the dosage needs to be reduced and the patient monitored very closely for signs of digoxin toxicity.
肾病损可能导致身体地高辛积累。如果有肾功能障碍，剂量必须减少，必须密切监护患者有无地高辛毒性体征。
The total drug regimen of the older patient should be coordinated, with careful attention to interacting drugs or alternative therapies.
老人的总体药物治疗方案必须协调，密切关注可相互作用的药物及另类疗法。
For backup in situations of stress or illness a significant other should be instructed in how to take the patient’s pulse and the adverse effects to watch for while the patient is taking this drug.
作为应激或疾病情况的后援，应教育一名有关系者知道如何测量患者脉搏及患者服药时需要留意的不良效应。
————Video ————
Heart Failure and Antihypertensives
————Tests ————
1. A patient with heart failure is taking Losartan and Spironolactone. The patient is having EKG changes that presents with tall peaked T-waves and flat p-waves. Which of the following lab results confirms these findings?
A. Na+ 135
B. BNP 560
C. K+ 8.0
D. K+ 1.5 2. During your morning assessment of a patient with heart failure, the patient complains of sudden vision changes that include seeing yellowish-green halos around the lights. Which of the following medications do you suspect is causing this issue?
A. Lisinopril
B. Losartan
C. Lasix
D. Digoxin
奥医教育“在线自测”题库 ISPN/RN复习练习、效果检验一站完成。
答案 Answer
1. C. Rationale: Losartan and Spironolactone can both cause an increased potassium level (hyperkalemia). Losartan is an ARB and Spironolactone is a potassium-sparing diuretic. Therefore, the EKG changes are a sign of a high potassium level (normal potassium level is 3.5-5.1). 2. D. Rationale: Yellowish-green halos/vision changes are classic signs of Digoxin toxicity.
当前位置：
