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 C
Explanation
Bile acid-binding resins are cholesterol-lowering agents that bind to bile acids in the intestine and prevent their reabsorption. This reduces the amount of bile acids available for cholesterol synthesis in the liver, which lowers the levels of LDL cholesterol in the blood. However, bile acids are also needed for the absorption of fat-soluble vitamins A, D, E, and K.Therefore, patients taking bile acid-binding resins may require supplements of these vitamins to prevent deficiency.
Choice A is wrong because nicotinic acid, or niacin, is a B vitamin that can lower cholesterol by limiting the production of fats in the liver.It does not affect the absorption of fat-soluble vitamins.
Choice B is wrong because nitroglycerin is not a cholesterol-lowering agent, but a vasodilator that relaxes the blood vessels and improves blood flow.It has no effect on fat-soluble vitamin absorption.
Choice D is wrong because beta blockers are not cholesterol-lowering agents, but drugs that lower blood pressure and heart rate by blocking the effects of adrenaline.They have no effect on fat-soluble vitamin absorption.
Correct Answer is A
Explanation
Terazosin is a medication that belongs to the class of alpha-adrenergic blockers, which relax the muscles in the prostate and bladder neck, making it easier to urinate.It also lowers blood pressure by relaxing the veins and arteries, allowing blood to flow more easily.Therefore, terazosin can cause dizziness or fainting, especially when getting up from a sitting or lying position.To prevent this, the patient should rise slowly and avoid standing for long periods or becoming overheated.
Choice B is wrong because terazosin is not a cure for benign prostatic hyperplasia (BPH), but a symptom reliever.Stopping the medication may cause the urinary problems to return or worsen.
The patient should continue taking terazosin as prescribed by the doctor, unless advised otherwise.
Choice C is wrong because decreasing fluid intake may increase the risk of dehydration, urinary tract infections, bladder stones, and kidney problems.
The patient should drink enough fluids to stay hydrated and flush out the urinary system.
Choice D is wrong because grapefruit juice may interact with terazosin and increase its blood levels, leading to more side effects such as low blood pressure, drowsiness, or headache.
The patient should avoid drinking grapefruit juice while taking terazosin, or consult the doctor before doing so.
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