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
Propranolol is a beta-blocker that can cause bronchoconstriction and worsen asthma symptoms.
Asthma is a reversible airway disease that is a contraindication for taking propranolol.
Choice A, tachycardia, is not a contraindication for taking propranolol.In fact, propranolol can be used to treat some types of tachycardia, such as atrial fibrillation or supraventricular tachycardia, by slowing down the heart rate.
Choice C, hypertension, is not a contraindication for taking propranolol.Propranolol can be used to treat hypertension by reducing the cardiac output and peripheral resistance.
Choice D, glaucoma, is not a contraindication for taking propranolol.Propranolol does not affect the intraocular pressure or the aqueous humor production.However, some other beta-blockers, such as timolol, can be used to treat glaucoma by lowering the intraocular pressure.
Correct Answer is D
Explanation
This is because digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and require dose adjustment or discontinuation of the medication.Digoxin helps make the heart beat stronger and with a more regular rhythm by inhibiting sodium-potassium ATPase in cardiac cells.It is used to treat heart failure and atrial fibrillation.
Choice A is wrong because increasing sodium intake can worsen fluid retention and exacerbate heart failure symptoms.Patients with heart failure should follow a low-sodium diet to reduce the workload on the heart.
Choice B is wrong because checking pulse rate for 30 seconds and multiplying result by 2 is not accurate enough to monitor the effects of digoxin.
Patients taking digoxin should check their pulse rate for one full minute before taking each dose and record it daily.If the pulse rate is too fast or too slow, they should contact their provider.
Choice C is wrong because taking digoxin with food may reduce its absorption and effectiveness.Digoxin should be taken on an empty stomach, at least one hour before or two hours after a meal.If nausea occurs, it may be a sign of digoxin toxicity and should be reported to the provider.
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