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.
Potassium 4.8 mEq/L.
Calcium 10.3 mg/dL.
The Correct Answer is A
This is because digoxin inhibits the Na-K-ATPase pump on the membrane of cardiac cells, which can cause extracellular potassium levels to rise. Hypokalemia (low potassium) caused by large dosages of diuretics may result in digoxin toxicity even at low serum digoxin levels. Digoxin toxicity can cause gastrointestinal, constitutional, and/or cardiovascular symptoms, as well as ECG changes such as signs of increased automaticity and atrioventricular node blockade.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range of 8.5 to 10.5 mg/dL. Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.
Choice C is wrong because potassium 4.8 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.
Hyperkalemia (high potassium) can also increase the risk of digoxin toxicity, but this is not the case here.
Choice D is wrong because calcium 10.3 mg/dL is within the normal range of 8.5 to 10.5 mg/dL. Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Urecholine is the brand name of bethanechol, a drug that belongs to the class of cholinergics, genitourinary.
Choice A is wrong because adrenergic drugs are those that activate the sympathetic nervous system, which is responsible for the fight-or-flight response.Adrenergic drugs can cause relaxation of the bladder and urinary retention, not contraction and emptying.
Choice B is wrong because anticholinergic drugs are those that block the action of acetylcholine, a neurotransmitter that mediates the parasympathetic nervous system, which is responsible for the rest-and-digest response.Anticholinergic drugs can also cause relaxation of the bladder and urinary retention, not contraction and emptying.
Choice D is wrong because adrenergic blockers are those that inhibit the action of adrenergic receptors, which are activated by adrenergic drugs or by the natural neurotransmitters norepinephrine and epinephrine.Adrenergic blockers can have various effects on the bladder depending on the type and location of the receptors they block, but they are not used to treat urinary retention.
Correct Answer is D
Explanation
Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.
Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.
Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.
Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.
Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.
Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.
Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.
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