A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin.
Which of the following electrolyte values increases a client's risk for digoxin toxicity?
Potassium 3.0 mEq/L.
Calcium 9.2 mg/dL.
Sodium 140 mEq/L.
Magnesium 2.2 mg/dL.
The Correct Answer is A
This is because low potassium levels (hypokalemia) increase the sensitivity of the heart to digoxin and can lead to toxicity even with normal serum digoxin levels. Digoxin inhibits the sodium-potassium pump on the cardiac cells, which causes potassium to accumulate outside the cells. Low potassium levels in the blood create a larger gradient for potassium to move out of the cells, which enhances the effect of digoxin and can cause arrhythmias.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range (8.5 to 10.2 mg/dL) and does not increase the risk of digoxin toxicity. However, high calcium levels (hypercalcemia) can potentiate the effects of digoxin and cause toxicity.
Choice C is wrong because sodium 140 mEq/L is within the normal range (135 to 145 mEq/L) and does not increase the risk of digoxin toxicity. However, high sodium levels (hypernatremia) can reduce the binding of digoxin to the sodium-potassium pump and decrease its efficacy.
Choice D is wrong because magnesium 2.2 mg/dL is within the normal range (1.7 to 2.4 mg/dL) and does not increase the risk of digoxin toxicity. However, low magnesium levels (hypomagnesemia) can increase the sensitivity of the heart to digoxin and cause toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Intermittent claudication is a condition in which leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest. This is because the blood flow to the leg muscles is insufficient to meet the increased demand during exercise, but adequate at rest.Intermittent claudication is a common symptom of peripheral artery disease (PAD), which is a narrowing of the arteries that supply blood to the legs.
Choice B, sporadic ischemia, is wrong because it is not a specific medical term for a condition that causes leg pain.
Ischemia means reduced blood flow to a part of the body, which can cause pain, but it can be caused by various factors and affect different organs.
Choice C, angina, is wrong because it is a term for chest pain caused by reduced blood flow to the heart, not the legs.
Angina can also be triggered by physical activity and relieved by rest, but it is not related to PAD or leg ischemia.
Choice D, restless leg syndrome, is wrong because it is a condition that causes an uncomfortable urge to move the legs, usually at night or when lying down.
Restless leg syndrome does not cause pain or ischemia in the legs, and it is not improved by rest.It is thought to be related to a problem with the nervous system or iron deficiency.
Correct Answer is ["A","B"]
Explanation
Pentoxifylline is a medication that improves blood flow and oxygen delivery to the tissues in patients with peripheral vascular disease (PVD), a condition that causes narrowing of the arteries in the legs.Pentoxifylline can help reduce the symptoms of intermittent claudication, which is cramping pain in the legs that occurs with walking and improves with rest.
Choice A is correct because smoking is a major risk factor for PVD and quitting smoking can improve blood flow and prevent further damage to the arteries.
Choice B is correct because prolonged sitting or standing can reduce blood flow to the legs and worsen symptoms of PVD.
Patients should avoid crossing their legs, wearing tight clothing, or exposing their legs to cold temperatures.They should also elevate their legs when resting and move them frequently.
Choice C is wrong because pentoxifylline should be taken on an empty stomach, at least one hour before or two hours after meals, to increase its absorption and effectiveness.
Choice D is wrong because physical activity is beneficial for patients with PVD and intermittent claudication.
Exercise can improve blood circulation, increase muscle strength, reduce pain, and lower cardiovascular risk factors.Patients should be encouraged to walk regularly, as tolerated, and follow a supervised exercise program if available.
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