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 A
Explanation
Erectile dysfunction drugs should not be used when a patient is taking nitrates.This is because both types of drugs cause blood vessels to dilate, which can lead to a dangerous drop in blood pressure. This can increase the risk of heart attack, stroke or fainting.
Choice B is wrong because alpha-adrenergic blockers are sometimes used together with nitrates to treat high blood pressure and angina. They work by relaxing the smooth muscles of the blood vessels, which lowers blood pressure and improves blood flow.
Choice C is wrong because calcium channel blockers are also used to treat high blood pressure and angina. They work by blocking the entry of calcium into the muscle cells of the heart and blood vessels, which reduces the force of contraction and relaxes the blood vessels.
Choice D is wrong because beta-adrenergic blockers are another class of drugs that can be used with nitrates to treat high blood pressure and angina. They work by blocking the effects of adrenaline on the heart and blood vessels, which slows down the heart rate and lowers blood pressure.
Normal ranges for blood pressure vary depending on age, gender and other factors, but generally they are between 90/60 mmHg and 120/80 mmHg for healthy adults.
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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