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 way of standardizing the PT results across different laboratories.
Warfarin is a blood thinner that works by inhibiting the production of vitamin K-dependent clotting factors in the liver.
Therefore, warfarin prolongs the PT and increases the INR.The PT/INR test is used to monitor the effectiveness of warfarin therapy and adjust the dose accordingly.
Choice A is wrong because PTT stands for partial thromboplastin time, which is another measure of blood clotting time, but it reflects the activity of different clotting factors than PT.PTT is used to monitor heparin therapy, not warfarin therapy.
Choice C is wrong because aPTT stands for activated partial thromboplastin time, which is a variation of PTT that uses an activator to speed up the clotting time.Like PTT, aPTT is used to monitor heparin therapy, not warfarin therapy.
Choice D is wrong because ACT stands for activated clotting time, which is a measure of the whole blood clotting time.ACT is used to monitor high-dose heparin therapy during certain procedures, such as cardiac bypass surgery or angioplasty.
The normal ranges for these tests may vary depending on the laboratory and the method used, but generally, they are:
• PT: 10 to 13 seconds
• INR: 0.8 to 1.2 (without warfarin) or 2.0 to 3.0 (with warfarin)
• PTT: 25 to 35 seconds
• aPTT: 30 to 40 seconds
• ACT: 70 to 120 seconds
Correct Answer is A
Explanation
Lisinopril belongs to the class of drugs calledangiotensin-converting enzyme (ACE) inhibitors.ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, a hormone that causes blood vessels to narrow and raise blood pressure.By inhibiting this enzyme, ACE inhibitors relax and widen the blood vessels, lower blood pressure, and improve blood flow to the heart and kidneys.
Choice B.Candesartan is wrong because it belongs to the class of drugs calledangiotensin II receptor blockers (ARBs).ARBs work by blocking the action of angiotensin II on its receptors, preventing it from causing blood vessel constriction and high blood pressure.ARBs are similar to ACE inhibitors in their effects, but they do not affect the enzyme or the level of bradykinin, a peptide that can cause cough and angioedema as side effects of ACE inhibitors.
Choice C.Metoprolol is wrong because it belongs to the class of drugs calledbeta blockers.Beta blockers work by blocking the effects of adrenaline and other hormones that stimulate the heart and blood vessels, causing them to beat slower and with less force.Beta blockers lower blood pressure and reduce the workload on the heart.
Choice D.Amlodipine is wrong because it belongs to the class of drugs calledcalcium channel blockers.Calcium channel blockers work by blocking the entry of calcium into the muscle cells of the heart and blood vessels, causing them to relax and dilate.Calcium channel blockers lower blood pressure and improve blood flow to the heart.
Normal ranges for blood pressure vary depending on age, gender, and other factors, but generally, a systolic blood pressure (the top number) of less than 120 mmHg and a diastolic blood pressure (the bottom number) of less than 80 mmHg are considered normal for adults.A blood pressure of 130/80 mmHg or higher is considered high and may require treatment with medication.
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