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
Taking niacin with an NSAID such as ibuprofen can reduce flushing, the most common adverse effect of niacin therapy. Flushing is a side effect of taking large doses of niacin (vitamin B3) supplements.It happens when the niacin causes the small blood vessels in your skin to dilate so more blood can rush through.Flushing can cause skin redness, warmth, itching, tingling, or burning sensations.
Choice A is wrong because taking niacin before starting daily activities can increase the risk of flushing and interfere with your routine.Flushing usually occurs within 15 to 30 minutes of taking niacin and lasts for about an hour.
Choice B is wrong because taking niacin with a sedative can increase the risk of liver damage, especially if the sedative is acetaminophen (Tylenol).Niacin can also cause liver problems at high doses, so combining it with another liver-toxic drug is not advisable.
Choice C is wrong because taking niacin with grapefruit juice can increase the risk of side effects, such as low blood pressure, dizziness, or fainting.Grapefruit juice can interfere with the metabolism of some drugs, including niacin, and make them more potent or toxic.
Normal ranges for niacin intake vary depending on age and gender.The recommended dietary allowance (RDA) for adult males is 16 mg per day and for adult females is 14 mg per day.Higher doses of niacin may be prescribed by a doctor to treat high cholesterol or other conditions, but they should be taken under medical supervision and with caution.
Correct Answer is D
Explanation
Thrombolytic agents are a classification of drugs that dissolve blood clots by activating the enzyme plasmin, which breaks down the proteins (fibrins) that form clots. They are used for serious conditions, such as stroke, pulmonary embolism, or heart attack when the blood flow needs to be restored quickly.
Choice A is wrong because salicylates are anti-inflammatory drugs that inhibit the synthesis of prostaglandins, which are involved in inflammation and pain. They also have antiplatelet effects, but they do not dissolve existing clots.
Choice B is wrong because antiplatelets are drugs that prevent platelets from sticking together and forming clots. They are used to prevent clotting in conditions such as coronary artery disease, stroke, or peripheral arterial disease. They do not dissolve existing clots either.
Choice C is wrong because anticoagulants are drugs that prevent clots from forming by interfering with the clotting factors that are normally present in the blood.
They are used to treat or prevent conditions such as deep vein thrombosis, pulmonary embolism, or atrial fibrillation. They do not dissolve existing clots.
Normal ranges for clotting factors vary depending on the laboratory and the method used, but some common values are:
• Prothrombin time (PT): 11 to 13 seconds
• International normalized ratio (INR): 0.8 to 1.2
• Activated partial thromboplastin time (aPTT): 25 to 35 seconds
• Fibrinogen: 200 to 400 mg/dL
• D-dimer: less than 0.5 mcg/mL
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