A mother calls the nurse to report that at 0900 she administered an oral dose of digoxin to her 4-month-old infant, but at 0920 the baby vomited the medicine. Which instruction should the nurse provide to this mother?
Administer a half dose now.
Give another dose.
Mix the next dose with food.
Withhold this dose.
The Correct Answer is D
Choice A: Administering a half dose now is not advisable, because it may result in underdosing or overdosing of digoxin. Digoxin has a narrow therapeutic range and a high risk of toxicity, especially in infants and children. The amount of digoxin absorbed by the infant before vomiting is unknown, so giving a partial dose may not achieve therapeutic levels or may exceed safe levels.
Choice B: Giving another dose is not advisable, because it may result in overdosing of digoxin. Digoxin has a narrow therapeutic range and a high risk of toxicity, especially in infants and children. The amount of digoxin absorbed by the infant before vomiting is unknown, so giving a full dose may exceed safe levels and cause adverse effects such as nausea, vomiting, bradycardia, arrhythmias, or visual disturbances.
Choice C: Mixing the next dose with food is not advisable, because it may affect the absorption and bioavailability of digoxin. Digoxin should be taken on an empty stomach or at least one hour before or two hours after meals, because food can interfere with its absorption from the gastrointestinal tract and reduce its effectiveness.
Choice D: Withholding the dose is the safest option. If vomiting occurs within 30 minutes of administration, it’s generally advised to skip that dose to avoid the risk of overdose. The next dose should be given as scheduled Digoxin has a long half-life and accumulates in tissues, so missing one dose will not significantly affect its therapeutic effect. Withholding this dose will avoid overdosing and toxicity of digoxin, which can be life-threatening in infants and children. The nurse should also advise the mother to resume the regular dosing schedule and monitor the infant's pulse rate and signs of digoxin toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E"]
Explanation
Choice C reason: Initiating patient controlled analgesia (PCA. pumps for two clients immediately postoperatively is not a nursing action that can be assigned to the PN. PCA pump is a device that allows the client to self-administer pain medication through an IV line by pressing a button. PCA pump should be initiated by the nurse after verifying the prescription, setting the parameters, educating the client, and ensuring safety and effectiveness. The PN does not have the authority or competency to initiate PCA pump or adjust its settings.
Choice D reason: Starting the second blood transfusion for a client twelve hours following a below knee amputation is not a nursing action that can be assigned to the PN. Blood transfusion is a procedure that delivers donated blood or blood products into the client's bloodstream through an IV line. Blood transfusion should be started by the nurse after verifying the prescription, checking the blood type and compatibility, obtaining informed consent, and monitoring for any adverse reactions. The PN does not have the authority or competency to start blood transfusion or manage its complications.
Correct Answer is B
Explanation
Choice B is correct because the client with antisocial behavior is at risk of being harmed by other clients or harming others. The nurse should intervene immediately to prevent violence and ensure safety.
Choice A is incorrect because the client with anorexia nervosa who is refusing to eat the evening snack is not in immediate danger. The nurse should monitor the client's nutritional status and weight, but this can be done later.
Choice C is incorrect because the client with bipolar disorder who is pacing around the lobby is not in immediate danger. The nurse should assess the client's mood and energy level, but this can be done later.
Choice D is incorrect because the client with major depression who refuses to participate in group is not in immediate danger. The nurse should encourage the client to join the group, but this can be done later.
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