Nokea
A patient has a digoxin level of 1.1 ng/mL. Which interpretation by the nurse is correct?
- A. It is below the therapeutic level.
- B. It is within the therapeutic range.
- C. It is above the therapeutic level.
- D. It is at a toxic level.
Correct Answer: B
Rationale: The normal therapeutic drug level of digoxin is between 0.5 and 2 ng/mL. The other options are incorrect.
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A patient in the intensive care unit is on a dobutamine infusion and is to receive furosemide 40 mg IV now. What is the nurse's best action to administer the furosemide?
- A. Infuse the drug into the same intravenous line as the milrinone.
- B. Stop the milrinone, flush the line, and then administer the furosemide.
- C. Administer the furosemide in a separate intravenous line.
- D. Notify the prescriber that the furosemide cannot be given at this time.
Correct Answer: C
Rationale: Furosemide must not be injected into an intravenous line with milrinone because it will precipitate immediately. The infusion must not be stopped because of the patient's condition. A separate line will be needed. The other options are incorrect.
A patient is taking digoxin and a loop diuretic daily. When the nurse enters the room with the morning medications, the patient states, -I am seeing a funny yellow color around the lights. What is the nurse's next action?
- A. Assess the patient for symptoms of digoxin toxicity.
- B. Withhold the next dose of the diuretic.
- C. Administer the digoxin and diuretic together as ordered.
- D. Document this finding, and reassess in 1 hour.
Correct Answer: A
Rationale: Seeing colors around lights is one potential indication of developing digoxin toxicity. If a patient indicates these visual problems, the nurse needs to assess for other signs and symptoms of digoxin toxicity including bradycardia, headache, dizziness, confusion, nausea, and blurred vision, and then notify the prescriber. Administering the drug or withholding the diuretic are incorrect options.
The nurse administering the phosphodiesterase inhibitor milrinone recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?
- A. Increased heart rate
- B. Increased blood vessel dilation
- C. Increased force of cardiac contractions
- D. Increased conduction of electrical impulses across the heart
Correct Answer: C
Rationale: Positive inotropic drugs increase myocardial contractility, thus increasing the force of cardiac contractions. Positive chronotropic drugs increase the heart rate. Positive dromotropic drugs increase the conduction of electrical impulses across the heart. Blood vessel dilation is not affected.
A patient about to receive a morning dose of digoxin has an apical pulse of 50 beats/min. What will the nurse do next?
- A. Administer the dose.
- B. Administer the dose, and notify the prescriber.
- C. Check the radial pulse for 1 full minute.
- D. Withhold the dose, and notify the prescriber.
Correct Answer: D
Rationale: Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. The other options are incorrect.
When administering digoxin immune Fab to a patient with severe digoxin toxicity, the nurse knows that each vial can bind with how much digoxin?
- A. 0.5 mg
- B. 1 mg
- C. 1.5 mg
- D. 2 mg
Correct Answer: A
Rationale: Each vial of digoxin immune Fab (Digifab) can bind approximately 0.5 mg of digoxin, helping to neutralize the drug in cases of severe toxicity.