A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Taking an HMG CoA reductase inhibitor.

Having a 10-year history of COPD.

Taking a high-ceiling diuretic.

Having a prolapsed mitral valve.

Answer and Explanation

The Correct Answer is C

Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.

Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.

Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.

Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.

COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.

Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.

A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.

A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.

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Correct Answer is A

Explanation

The nurse should plan to take the following action:

A) Mix the medications with a semisolid food for the client.

Mixing the medications with a semisolid food, such as applesauce or pudding, can make it easier for an older adult client with dysphagia to swallow the medications safely. It helps in reducing the risk of choking and aspiration. This approach is typically used for clients who have difficulty swallowing pills.

Options B, C, and D are not recommended for a client with dysphagia:

B) Administering more than one pill at a time can increase the risk of choking and aspiration, which should be avoided.

C) Placing medications on the back of the client's tongue can also lead to difficulty swallowing and an increased risk of aspiration.

D) Tilting the client's head back when administering medications is not recommended as it can lead to aspiration. The head should be kept in a neutral position to support safe swallowing.

A. Discard the medication if it is yellow. B. Use a gravity flow set. C. Prime the tubing with 0.9% sodium chloride. D. Administer the medication over 2 hr.

Correct Answer is D

Explanation

The correct answer is d. Administer the medication over 2 hr.

Choice A reason: Discarding the medication if it is yellow is not necessary. The color of amphotericin B lipid complex does not indicate its effectiveness or safety.

Choice B reason: Using a gravity flow set is not specifically required for the administration of amphotericin B lipid complex. Gravity infusion can be used to administer fluids and drugs where the rate is not critical and serious adverse effects are not anticipated. However, the use of a gravity flow set is not specifically mentioned in the guidelines for administering amphotericin B lipid complex.

Choice C reason: Priming the tubing with 0.9% sodium chloride is not recommended for amphotericin B lipid complex. This is because amphotericin B lipid complex is incompatible with saline solutions and should be diluted only with 5% dextrose injection. Priming the tubing is a common practice in IV therapy to remove air from the tubing before attaching it to the patient.

Choice D reason: Administering the medication over 2 hr is the correct action. Amphotericin B lipid complex is typically administered over a longer period, often 2-6 hours. This allows for a slow and steady delivery of the medication, which can help to minimize potential side effects.

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A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?

Nursing Test Bank

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