A nurse is caring for a client who has heart failure and a prescription for digoxin 125 mcg PO daily. Available is digoxin PO 0.25 mg/tablet. How many tablets should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

Answer: B

Rationale:

A. Radial vein in the wrist: The radial vein is not commonly used for IV catheter insertion due to its location and size. The wrist veins can be smaller and more difficult to cannulate compared to veins in the forearm or antecubital area.

B. Median vein in the forearm: The median vein in the forearm is a preferred site for IV catheter insertion in older adults. It is generally more accessible and less prone to complications than veins in the hand or wrist, making it a suitable choice for stable, longer-term access.

C. Dorsal metacarpal vein: While the dorsal metacarpal veins on the hand can be used for IV insertion, they are typically smaller and more difficult to access than veins in the forearm. Additionally, veins in the hand can be more prone to irritation and complications.

D. Ante-cubital vein: The antecubital vein (such as the median cubital vein) is a good site for IV insertion due to its size and accessibility, especially for larger gauge catheters or when longer-term access is needed. However, it is often preferred for more acute situations rather than routine outpatient procedures.

A. Inverted P wave: An inverted P wave may indicate atrial depolarization abnormalities but is not typically associated with hypokalemia. It can be seen in conditions such as atrial enlargement or atrial ischemia. However, in hypokalemia, the P wave may become flattened or have a decreased amplitude, but it is less likely to be inverted.
B. Wide QRS: A wide QRS complex may indicate conduction abnormalities or bundle branch blocks, but it is not specifically associated with hypokalemia. Wide QRS complexes are more commonly seen in conditions such as bundle branch blocks or electrolyte imbalances like hyperkalemia. Hypokalemia tends to cause a prolongation of the QT interval rather than widening of the QRS complex.
C. Elevated ST segment: An elevated ST segment is typically associated with myocardial injury or infarction, not hypokalemia. It can be indicative of conditions such as myocardial ischemia or pericarditis. In hypokalemia, ST segment changes are more likely to be flattened or depressed rather than elevated.
D. Abnormally prominent U wave: An abnormally prominent U wave is a classic EKG finding in hypokalemia. Hypokalemia prolongs the repolarization phase of the cardiac action potential, leading to the appearance of U waves following the T wave. These U waves can become more pronounced as potassium levels decrease. Therefore, an abnormally prominent U wave is a significant indicator of hypokalemia on an EKG, especially in a patient with prolonged vomiting, which can lead to potassium depletion. Thus, it is the most pertinent abnormality to interpret in this context.