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. Metabolic alkalosis is characterized by an increase in bicarbonate (HCO3-) levels in the blood, resulting in an elevated pH (>7.45). Shallow respirations are less likely to cause metabolic alkalosis directly.
B. This is not likely the initial risk. Respiratory alkalosis occurs due to hyperventilation, leading to excessive elimination of CO2 (carbon dioxide), which raises the blood pH (>7.45). Shallow respirations typically result in retention of CO2, leading to respiratory acidosis rather than alkalosis.
C. Metabolic acidosis occurs when there is an increase in acid (decreased pH <7.35) or a decrease in bicarbonate levels in the blood. Shallow respirations can lead to hypoventilation and retention of CO2, resulting in respiratory acidosis initially.
D. Shallow respirations at a rate of 9 breaths per minute reduce the elimination of CO2, leading to its accumulation in the blood. This accumulation lowers the blood pH (<7.35), causing respiratory acidosis. Therefore, the client is initially at risk for developing respiratory acidosis due to ineffective ventilation.

Correct Answer is ["28"]

Explanation

(Volume in mL * Drop Factor) / Time in minutes.

Volume is 1,000 mL, the drop factor is 10 gtt/mL, and the time is 6 hours.

First, convert the hours into minutes (6 hours * 60 minutes/hour = 360 minutes). Then, multiply the volume by the drop factor (1,000 mL * 10 gtt/mL = 10,000 gtt).

Finally, divide this number by the total time in minutes (10,000 gtt / 360 minutes ≈ 27.78

gtt/min).

Rounding to the nearest whole number, the nurse should set the manual IV infusion to deliver 28 gtt/min.

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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 caring for a client who is postoperative and whose respirations are shallow and 9/min. Which of the following acid-based imbalances should the nurse identify the client as being at risk for developing initially?

Correct Answer is D

Explanation

Correct Answer is ["28"]

Explanation

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