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
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
Correct Answer is C
Explanation
This is because elevating the legs can help reduce swelling and improve blood flow back to the heart by reducing the effects of gravity.Elevating the legs can also prevent blood from pooling in the veins and reduce the risk of blood clots.
Choice A is wrong because dangling the legs can increase swelling and pressure in the veins, which can worsen peripheral venous disease (PVD) symptoms and complications.
Choice B is wrong because sitting in one position for prolonged hours can impair blood circulation and increase the risk of blood clots, especially in the lower legs.People with PVD should avoid crossing their legs, wearing tight clothing, or sitting for long periods without moving.
Choice D is wrong because standing in one position can also increase swelling and pressure in the veins, which can lead to pain, ulcers, and skin changes.People with PVD should avoid standing for long periods without moving or changing positions.
Some additional information:
Peripheral venous disease (PVD) is a condition that affects blood flow in the veins and arteries outside of your heart and brain.
It can be caused by narrowing, blocking, or spasming of the blood vessels, or by blood clots in the veins.PVD can cause pain and fatigue, especially in the legs, and can lead to serious complications such as gangrene or amputation.
The most common cause of PVD is atherosclerosis, the buildup of plaque inside the artery wall.
Plaque reduces the amount of blood flow to the limbs and decreases the oxygen and nutrients available to the tissue.Other causes of PVD may include injury, infection, irregular anatomy of muscles or ligaments, or inflammation of the blood vessels.
The normal range of blood pressure in the veins is about 10 to 20 mmHg.
The normal range of oxygen saturation in the veins is about 60 to 80%.
The normal range of pulse rate in the veins is about 60 to 100 beats per minute.
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