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?

Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.

Choice A. Administer medication is wrong because it could harm the patient as explained above.

Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.

The nurse should not delay notifying the provider about the patient’s condition.

Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.

The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.

Antidigoxin is an antidote for digoxin toxicity that binds and inactivates digoxin, a cardiac glycoside that can cause life-threatening arrhythmias, hyperkalemia, and other symptoms when overdosed.Antidigoxin is also known as digoxin immune Fab or DIGIFab.

Choice A, protamine sulfate, is wrong because it is an antidote for heparin, an anticoagulant that can cause bleeding when overdosed.

Choice B, acetylcysteine, is wrong because it is an antidote for acetaminophen, a painkiller that can cause liver damage when overdosed.

Choice D, activated charcoal, is wrong because it is a nonspecific adsorbent that can reduce the absorption of some drugs or poisons from the gastrointestinal tract, but it is not effective for digoxin toxicity.