Nokea
A client comes to the clinic for a visit. The client has been taking digoxin for several months. While interviewing the client, the nurse suspects the client is experiencing digoxin toxicity based on which of the following? Select all that apply.
- A. Anorexia
- B. Weakness
- C. Inability to relax
- D. Photosensitivity
- E. Disorientation
Correct Answer: A,B,E
Rationale: Signs of digitalis toxicity include anorexia, weakness, lethargy, blurred vision, and disorientation. An inability to relax and photosensitivity are not associated with digitalis toxicity.
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A nurse caring for a client with atrial fibrillation who is started on digoxin therapy is required to monitor plasma drug levels. The nurse would report which level to the primary health care provider?
- A. 1.6 ng/ml
- B. 1.8 ng/ml
- C. 2.0 ng/ml
- D. 2.2 ng/ml
Correct Answer: D
Rationale: A plasma digoxin level of more than 2 ng/mL would require the nurse to report to the primary health care provider; therefore, plasma digitalis levels of 2.2 ng/mL indicate digoxin toxicity. The therapeutic levels range from 0.5 to 2 ng/mL.
A client is receiving maintenance therapy with digoxin. The nurse understands that which form would be used? Select all that apply.
- A. Capsule
- B. Injection
- C. Ointment
- D. Patch
- E. Tablet
Correct Answer: A,E
Rationale: Capsules and tablets are used for maintenance therapy, injections are used for rapid digitalization, and digoxin patches and ointment do not exist.
After receiving a loading dose of milrinone (Primacor), the nurse would assess the client for which of the following as most likely? Select all that apply.
- A. Hypertension
- B. Angina
- C. Hyperkalemia
- D. Headache
- E. Insomnia
Correct Answer: B,D
Rationale: The adverse reactions most likely to occur after the administration of milrinone (Primacor) to a client are ventricular arrhythmias, hypotension, angina, chest pain, headache, and hypokalemia.
Before administering a cardiotonic drug, the nurse would expect which of the following laboratory tests to be completed? Select all that apply.
- A. Liver function tests
- B. Renal function tests
- C. Complete blood count
- D. Electrolyte levels
- E. Blood glucose
Correct Answer: A,B,C,D
Rationale: Liver function tests, renal function tests, complete blood count with the addition of serum electrolytes, and an electrocardiogram complete the lab workup prior to initiating therapy with a cardiotonic drug. It is not necessary to obtain serum blood glucose, but it might appear with other lab work that has been gathered.
To help control the nausea and anorexia that may occur as an adverse reaction during digoxin therapy, the nurse should recommend which of the following? Select all that apply.
- A. Eating frequent smaller meals
- B. Restricting fluids at mealtime
- C. Maintaining good oral hygiene
- D. Eating more protein
- E. Avoiding fluid intake 1 hour before and after meals
Correct Answer: A,B,C,E
Rationale: If the nausea or anorexia is not a result of toxicity but an adverse reaction to the drug, use nursing measures to help control the reactions. Offer frequent small meals rather than three large meals. Restricting fluids at meals and avoiding fluids 1 hour before and after meals help to control nausea. Helping the patient to maintain good oral hygiene by brushing teeth or rinsing the mouth after ingesting food will also help with nausea.