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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["167"]
Explanation
1 kilogram is equivalent to 2.2 pounds.
The client weighs 245 lbs, which is approximately 111.36 kg (245 lbs / 2.2). The prescribed dosage is 1.5 mg per kilogram.
Therefore, the dosage per dose would be 1.5 mg/kg * 111.36 kg, which equals 167.04 mg. Rounded to the nearest whole number, the nurse should administer 167 mg per dose.
Correct Answer is D
Explanation
A. Serum sodium levels are typically assessed to evaluate electrolyte balance and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
B. This could be ordered for various reasons such as assessing lung status or identifying any abnormalities in the chest. It is not directly related to monitoring warfarin therapy.
C. BUN levels are measured to assess kidney function and hydration status. While important for overall health assessment, it is not specifically related to monitoring the effects of warfarin therapy.
D. The INR is a standardized measurement of the blood's ability to clot. Warfarin works by inhibiting vitamin K-dependent clotting factors, thereby prolonging the time it takes for blood to clot. The INR is used to monitor and adjust warfarin dosage to maintain therapeutic anticoagulation levels, especially in patients with conditions like atrial fibrillation who are at risk of blood clots.
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