A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Hemoglobin

Creatinine

Blood urea nitrogen

Potassium

Answer and Explanation

The Correct Answer is A

A.   Hemoglobin levels are important for assessing oxygen-carrying capacity of the blood. While anemia can affect tissue oxygenation and exacerbate symptoms in heart failure, it is not directly related to the risk of digoxin toxicity.
B.   Creatinine levels are used to assess kidney function. Impaired kidney function can affect the clearance of digoxin from the body, potentially increasing the risk of toxicity. However, potassium levels have a more direct impact on the risk of digoxin toxicity.
C.   BUN levels are also used to assess kidney function. Similar to creatinine, impaired kidney function can affect digoxin clearance, but potassium levels are more directly related to the risk of digoxin toxicity.
D.   Potassium levels are critical because hypokalemia (low potassium) can predispose the client to digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can bind more readily to these pumps, leading to increased toxicity and potentially life-threatening arrhythmias such as ventricular tachycardia or ventricular fibrillation.

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Correct Answer is D

Explanation

A. Applying a warm compress can help dilate the blood vessels, potentially improving circulation around the IV site. This can sometimes alleviate discomfort caused by irritation or infiltration. However, if there is significant pain or swelling, warm compresses may not be sufficient.
B. Applying firm pressure on the syringe plunger during the flush is not recommended. Excessive force could potentially cause damage to the vein or exacerbate pain and discomfort. It's important to flush gently to maintain patency and avoid causing further irritation or complications.
C. If the client reports pain above the IV saline lock and there are signs of infiltration (such as swelling, coolness, or blanching of the skin around the site), removing the IV saline lock may be necessary. Infiltration occurs when IV fluid leaks into the surrounding tissue instead of flowing into the vein, which can lead to discomfort and complications.
D. Injecting the solution more slowly during the flush can help minimize discomfort and reduce the risk of causing further damage. Slower infusion allows for better tolerance by the vein and surrounding tissues, decreasing the likelihood of pain or infiltration.

A. Deferasirox B. Protamine sulfate C. Acetylcysteine D. Vitamin K

Correct Answer is B

Explanation

A. Deferasirox is a medication used to treat chronic iron overload due to blood transfusions. It is not used as an antidote for heparin.
B. Protamine sulfate is the antidote for heparin. It works by binding to heparin, neutralizing its anticoagulant effects. Protamine sulfate is typically used in cases of heparin overdose or when rapid reversal of heparin's effects is necessary, such as during surgery or if there is active bleeding.
C. Acetylcysteine is used as an antidote for acetaminophen (paracetamol) overdose due to its ability to replenish glutathione stores in the liver and protect against liver damage. It has no role in reversing heparin's effects.
D. Vitamin K is the antidote for warfarin, not heparin. It promotes the synthesis of clotting factors in the liver that are inhibited by warfarin, thus reversing its anticoagulant effects.

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A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is attempting to flush the IV saline lock for a client. The client reports pain above se should monitor the client for whic: flush. Which of the following actions should the nurse take?

Correct Answer is D

Explanation

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Correct Answer is B

Explanation

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