A nurse in a pediatric clinic is providing teaching to the guardian of an infant who has a new prescription for digoxin. Which of the following manifestations should the nurse include as an indication of digoxin toxicity?

In teaching parents of a preschool-age child with heart failure, the nurse should include the following information:

Choice A Reason:

Withhold digoxin if the child's pulse is greater than 100/min. While monitoring the pulse rate is important in children taking digoxin, a pulse rate greater than 100/min alone may not always indicate the need to withhold digoxin. The decision to withhold digoxin should be based on healthcare provider instructions and specific parameters provided for the child's case.

Choice B Reason:

Increase the child's oxygen flow rate until the child no longer has cyanosis. Adjusting oxygen flow rates should be done under the guidance of healthcare providers and based on prescribed protocols. Cyanosis is a serious sign indicating decreased oxygenation and should be addressed promptly by seeking medical attention rather than attempting to adjust oxygen flow rates at home.

Choice C Reason:

Weigh the child once each month. Monitoring the child's weight is important in heart failure management to track fluid retention, but weighing the child once a month may not provide sufficient monitoring. The healthcare provider might recommend more frequent weight checks to monitor fluid status accurately.

Choice D Reason:

Provide for periods of rest. Children with heart failure often have limited cardiac reserve and can easily become fatigued. Allowing the child periods of rest is essential to conserve energy and prevent excessive fatigue or exhaustion.

Correct answer: C

Choice A Reason:

Instructing the child to drink fluids through a straw should be avoided immediately after a tonsillectomy. The sucking motion required when using a straw can potentially disrupt the healing process and dislodge the blood clot at the surgical site, leading to bleeding. Therefore, this action is not recommended.

Choice B Reason:

Avoid milk products such as milk, icecream and pudding initially because they coat the throat, causing the child to cough to clear the throat.

Choice C Reason:

Placing the child in a side-lying position helps maintain an open airway and allows drainage of saliva and potential blood.

Choice D Reason:

Encouraging the child to deep breath and cough is generally a good practice to prevent respiratory complications post-anesthesia. However, immediate post-tonsillectomy, the focus might be more on airway patency and monitoring for signs of bleeding or adverse reactions rather than deep breathing and coughing.