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 where leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest.This is because the lack of oxygen to the muscles causes pain, and resting allows the blood flow to resume.
Choice B, sporadic ischemia, is wrong because it is not a specific condition, but a general term for reduced blood supply to a tissue or organ.
Choice C, angina, is wrong because it is a chest pain caused by reduced blood flow to the heart, not the legs.
Choice D, paresthesia, is wrong because it is a sensation of tingling, numbness, or prickling in the skin, not pain.
It can be caused by various conditions, such as nerve damage, diabetes, or Raynaud’s disease.
Correct Answer is D
Explanation
This is because nitroglycerin patches can cause tolerance if they are used continuously, which reduces their effectiveness in preventing angina attacks. Removing the patch each evening allows the body to restore its sensitivity to the drug.
Choice A is wrong because nitroglycerin patches should be applied every 24 hours, not every 48 hours.
Applying a new patch every 48 hours would result in inadequate blood levels of the drug and increased risk of angina.
Choice B is wrong because nitroglycerin patches should not be cut in half or altered in any way.
Cutting the patch would compromise the integrity of the drug delivery system and could lead to unpredictable or excessive doses of the drug.
Choice C is wrong because nitroglycerin patches should not be taken off for 30 minutes if a headache occurs.
Headache is a common side effect of nitroglycerin due to its vasodilating action, but it usually subsides with continued use.
Taking off the patch for 30 minutes could increase the risk of angina by interrupting the steady blood levels of the drug.
The nurse should advise the client to take an analgesic such as acetaminophen for headache relief.
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