Nokea
A client receives his prescribed daily digoxin at 9 a.m. today. The nurse would expect to obtain a serum drug level at which time?
- A. 12 noon today
- B. 4 p.m. today
- C. 9 p.m. tonight
- D. 12 midnight
Correct Answer: B
Rationale: Blood for plasma level measurements should be drawn immediately before the next dose or 6 to 8 hours after the last dose regardless of route. For this client, that would be between 3 p.m. and 5 p.m. today or immediately before his dose tomorrow.
You may also like to solve these questions
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.
A nurse checks the serum digoxin level of a client and finds it to be increased. Which of the following would the nurse identify as possibly associated with this increase?
- A. Colestipol (Colestid)
- B. Verapamil (Calan)
- C. Clarithromycin (Biaxin)
- D. Calcium carbonate (Maalox)
- E. Spironolactone (Aldactone)
Correct Answer: B,C,E
Rationale: Increased serum digoxin levels can occur with verapamil, clarithromycin, and spironolactone. Antacids, such as calcium carbonate, and colestipol cause a decrease in serum digoxin levels.
When reviewing the medical record of a client who is prescribed a cardiotonic, which condition would lead the nurse to contact the primary health care provider because the drug is contraindicated for use? Select all that apply.
- A. Digitalis toxicity
- B. Hypertension
- C. Cardiac tamponade
- D. Hypotension
- E. Ventricular tachycardia
Correct Answer: A,C,E
Rationale: The cardiotonics are contraindicated in the presence of digitalis toxicity and in clients with known drug hypersensitivity, ventricular tachycardia, cardiac tamponade, restrictive cardiomyopathy, or AV block.
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.
After teaching a group of nursing students about digoxin, the instructor determines that the teaching was successful when the students identify which of the following as true regarding the monitoring of plasma digoxin levels? Select all that apply.
- A. Levels should be drawn immediately after the dose.
- B. Levels should be drawn immediately before the next dose.
- C. Levels should be drawn 6 to 8 hours after the last dose.
- D. Levels of greater than 2 ng/ml are considered toxic.
- E. Levels are considered therapeutic between 0.5 and 1.5 ng/ml.
Correct Answer: B,C,D
Rationale: Digoxin blood plasma level measurements should be drawn immediately before the next dose or 6 to 8 hours after the last dose regardless of route. Therapeutic digoxin levels are between 0.8 and 2 ng/ml. Plasma digoxin levels greater than 2 ng/ml are considered toxic and are reported to the physician.