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 D
Explanation
This is because digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and require dose adjustment or discontinuation of the medication.Digoxin helps make the heart beat stronger and with a more regular rhythm by inhibiting sodium-potassium ATPase in cardiac cells.It is used to treat heart failure and atrial fibrillation.
Choice A is wrong because increasing sodium intake can worsen fluid retention and exacerbate heart failure symptoms.Patients with heart failure should follow a low-sodium diet to reduce the workload on the heart.
Choice B is wrong because checking pulse rate for 30 seconds and multiplying result by 2 is not accurate enough to monitor the effects of digoxin.
Patients taking digoxin should check their pulse rate for one full minute before taking each dose and record it daily.If the pulse rate is too fast or too slow, they should contact their provider.
Choice C is wrong because taking digoxin with food may reduce its absorption and effectiveness.Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal.If nausea occurs, it may be a sign of digoxin toxicity and should be reported to the provider.
Correct Answer is ["A","B","D","E"]
Explanation
These are all modifiable risk factors for cardiovascular disease, meaning they can be changed through lifestyle choices or medication.Cholesterol level, blood pressure, weight, and smoking all affect the health of the heart and blood vessels, and can increase the risk of developing conditions such as atherosclerosis, hypertension, heart attack, or stroke.
Choice C, family history, is not a modifiable risk factor for cardiovascular disease.
It is a non-modifiable risk factor, meaning it cannot be changed and is determined by genetics.
Having a family history of cardiovascular disease can increase the risk of developing it, but it does not mean that it is inevitable.Other non-modifiable risk factors include sex, older age, race and ethnicity.
Some normal ranges for the modifiable risk factors are:
• Cholesterol level: total cholesterol should be less than 200 mg/dL; LDL cholesterol should be less than 100 mg/dL; HDL cholesterol should be more than 40 mg/dL for men and more than 50 mg/dL for women; triglycerides should be less than 150 mg/dL.
• Blood pressure: normal blood pressure is less than 120/80 mmHg; elevated blood pressure is 120-129/less than 80 mmHg; hypertension stage 1 is 130-139/80-89 mmHg; hypertension stage 2 is 140 or higher/90 or higher mmHg.
• Weight: body mass index (BMI) is a measure of weight relative to height; normal BMI is 18.5-24.9 kg/m2; overweight BMI is 25-29.9 kg/m2; obese BMI is 30 or higher kg/m2.
• Smoking: smoking any amount of tobacco products can harm the cardiovascular system; quitting smoking can lower the risk of cardiovascular disease and improve overall health.
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