A client is being treated for heart failure. Labs: Sodium 146, Potassium 2.9, Hemoglobin 10.5, White Blood Cells 12.2 VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4F
What will the nurse do with the digoxin order?

Choice A reason: This statement is false. The nurse should not say that it is psychological, as this is not true and may offend the client. The difference between IV and oral medications is not based on the client's belief or perception, but on the pharmacokinetics of the drugs.

Choice B reason: This statement is true. The nurse's best response is to explain that oral medications take longer to absorb into the system than IV medications, as oral medications have to pass through the digestive tract and the liver before reaching the bloodstream. IV medications are injected directly into the vein and bypass the digestive tract and the liver. Therefore, IV medications have a faster onset of action and a higher bioavailability than oral medications.

Choice C reason: This statement is false. The nurse should not say that there is no difference between IV and oral medications, as this is not true and may confuse the client. IV and oral medications have different routes of administration, absorption, distribution, metabolism, and excretion. These factors affect the drug levels and effects in the body.

Choice D reason: This statement is false. The nurse should not say that IV medication doses are always higher than oral doses, as this is not true and may mislead the client. IV and oral medication doses are determined by the drug characteristics, the client's condition, and the desired outcome. Sometimes, IV medication doses are lower than oral doses, as IV medications have a higher bioavailability and a more potent effect than oral medications.

Choice A reason: This statement is true. The nurse's best recommendation is to give glucagon IM, as glucagon is a hormone that raises blood glucose levels by stimulating the breakdown of glycogen in the liver. Glucagon can be given intramuscularly, subcutaneously, or intranasally, and does not require an IV line. The client has a very low blood glucose level, which can cause brain damage or death if not treated promptly.

Choice B reason: This statement is false. The nurse should not recommend dextrose 50% IV, as dextrose is a form of glucose that is given intravenously to raise blood glucose levels. However, dextrose requires an IV line, which the nurse is unable to get. The nurse should look for alternative routes of administration that do not depend on an IV line.

Choice C reason: This statement is false. The nurse should not recommend insulin glargine SQ, as insulin is a hormone that lowers blood glucose levels by facilitating the uptake of glucose in the cells. Insulin glargine is a long-acting insulin that is given subcutaneously once a day. The client does not need insulin, as their blood glucose level is already too low. Giving insulin would worsen the client's condition and cause severe hypoglycemia.

Choice D reason: This statement is false. The nurse should not recommend diet cola PO, as diet cola is a sugar-free beverage that does not raise blood glucose levels. Diet cola is not a suitable treatment for hypoglycemia, as it does not provide any glucose to the body. Moreover, the client is lethargic and unable to follow commands, which means they may have difficulty swallowing or may aspirate the liquid. The nurse should avoid giving anything by mouth to the client until they are alert and oriented.