Nokea
The nurse is reviewing discharge teaching for a patient who will be taking digoxin therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?
- A. Leafy green vegetables
- B. Dairy products
- C. Grapefruit juice
- D. Bran muffins
Correct Answer: D
Rationale: Bran, in large amounts, may decrease the absorption of oral digitalis drugs. The other foods do not affect digoxin levels.
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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.
The medication order for a 5-year-old child reads, -Give digoxin elixir, 15 mcg/kg, PO now. Convert the 15 micrograms to milligrams.
Correct Answer: 0.015 mg
Rationale: 1000 mcg : 1 mg :: 15 mcg : x mg; (1000 * x) = (1 * 15); 1000x = 15; x = 15/1000 = 0.015 mg.
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.
When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune Fab?
- A. The patient reports seeing colorful halos around lights.
- B. The patient's serum potassium level is above 5 mEq/L.
- C. The patient is experiencing nausea and anorexia.
- D. The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing.
- E. The patient has received an overdose of greater than 10 mg of digoxin.
- F. The patient reports fatigue and headaches.
Correct Answer: B,D,E
Rationale: Clinical situations that would require the use of digoxin immune Fab in a patient with digoxin toxicity include serum potassium level above 5 mEq/L, severe sinus bradycardia that does not respond to cardiac pacing, or an overdose of more than 10 mg of digoxin. Seeing colorful halos around lights, nausea, anorexia, fatigue, and headaches are potential adverse effects of digoxin therapy but are not necessarily reasons for digoxin immune Fab treatment.