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 B
Explanation
PT stands for prothrombin time, which is a measure of how long it takes the blood to clot. INR stands for international normalized ratio, which is a standardized way of reporting the PT result. Warfarin is a blood thinner that works by slowing down the clotting process.Therefore, people who take warfarin need to have their PT/INR monitored regularly to make sure they are getting the right dose and not bleeding too much or too little.
Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting that is not affected by warfarin.PTT is used to monitor heparin, another type of blood thinner.
Choice C is wrong because CBC stands for complete blood count, which is a test that measures the number and types of cells in the blood, such as red blood cells, white blood cells and platelets.CBC can show if there is anemia, infection or bleeding, but it does not measure the effect of warfarin on clotting.
Choice D is wrong because LFTs stand for liver function tests, which are a group of tests that check how well the liver is working.
LFTs can show if there is liver damage or disease, which can affect how warfarin is metabolized and cleared from the body.However, LFTs do not directly measure the effect of warfarin on clotting.
The normal range for PT/INR varies depending on the laboratory and the reason for taking warfarin.
Generally, the normal range for PT is 10 to 13 seconds, and the normal range for INR is 1.1 or below for healthy people.For people taking warfarin, the target INR range depends on their condition and risk factors, but it is usually between 2.0 and 3.0.
Correct Answer is D
Explanation
Report any muscle pain or weakness to the healthcare provider.This is because simvastatin This is because simvastatin can cause a rare but serious side effect of muscle damage (rhabdomyolysis), which can lead to kidney failure.Muscle pain or weakness can be signs of muscle breakdown and kidney damage, and should be reported to the healthcare provider as soon as possible.
Choice A is wrong because changing position slowly when rising from a chair is not related to simvastatin.This is a precaution for people who take medications that lower blood pressure, such as diuretics or beta blockers, to prevent dizziness or fainting.
Choice B is wrong because maintaining a steady intake of green leafy vegetables is not specific to simvastatin.This is a general dietary recommendation for people who take anticoagulants, such as warfarin, to prevent bleeding complications.
Choice C is wrong because consuming no more than 1 L/day of fluid is not advised for people who take simvastatin.This is a restriction for people who have heart failure or kidney disease, to prevent fluid overload.People who take simvastatin should drink enough fluids to stay hydrated and avoid dehydration, which can increase the risk of kidney damage.
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