A nurse is reinforcing education about infection prevention to a group of clients at a community center. What information should the nurse include in the teaching?

Digoxin is commonly prescribed for heart failure and certain dysrhythmias such as atrial fibrillation. It has a narrow therapeutic index, meaning small changes in dose can lead to toxicity. Safe administration requires monitoring the apical pulse before each dose to prevent bradycardia and other adverse effects. Patient education focuses on safe dosing, toxicity recognition, and adherence.

Rationale:
A. Limiting intake of foods high in potassium is incorrect because digoxin toxicity is more likely when potassium levels are low (hypokalemia), not high. Adequate potassium levels help protect the myocardium from digoxin toxicity. Therefore, patients are usually encouraged to maintain normal potassium intake unless otherwise directed.

B. Checking the pulse for 1 minute before taking digoxin is essential because the medication can slow the heart rate. If the apical pulse is below the prescribed threshold (commonly <60 bpm in adults), the dose should be withheld and the provider notified. This helps prevent bradycardia and potential digoxin toxicity.

C. Taking digoxin every 6 hours is incorrect because it is typically administered once daily due to its long half-life. Frequent dosing increases the risk of accumulation and toxicity. The medication schedule should always follow the prescribed once-daily regimen.

D. Stating that digoxin should not be taken during pregnancy is incorrect because it may be used when clinically indicated under medical supervision. Although caution is required, digoxin is not absolutely contraindicated in pregnancy. Therapy decisions are based on maternal and fetal risk-benefit evaluation.

A fecal occult blood test (FOBT) is used to detect hidden blood in the stool that may indicate gastrointestinal bleeding, polyps, or colorectal cancer. Proper specimen collection is essential because certain foods, medications, and conditions can affect test accuracy and lead to false-positive or false-negative results. Clients are taught to follow dietary and medication restrictions and to collect samples over multiple bowel movements. Correct technique improves the reliability of screening results.

Rationale:
A. Collecting samples when hemorrhoids are bleeding is incorrect because visible blood from hemorrhoids can cause a false-positive result. The test is designed to detect occult (hidden) blood, not overt bleeding. Active hemorrhoidal bleeding should be reported, and testing may need to be postponed until bleeding resolves.

B. Continuing to take aspirin daily is incorrect because aspirin can irritate the gastrointestinal mucosa and increase the risk of bleeding, leading to a false-positive test result. Clients are typically instructed to avoid aspirin and other NSAIDs before and during stool collection unless otherwise directed by the provider.

C. Continuing to eat red meat is incorrect because red meat contains heme iron, which can cause a false-positive result on fecal occult blood testing. Clients are usually instructed to avoid red meat prior to and during testing to ensure accurate results. Diet restrictions help improve test specificity.

D. Collecting samples from three separate bowel movements is correct because multiple specimens increase the accuracy and reliability of fecal occult blood testing. Since bleeding in the gastrointestinal tract may be intermittent, obtaining samples over different bowel movements improves the likelihood of detecting occult blood. This ensures more accurate screening results.