A nurse is reinforcing teaching with a client who is starting digoxin therapy to treat heart failure. The nurse should reinforce with the client that which of the following adverse effects is a possible indication of digoxin toxicity and should be reported to the provider?
Tinnitus
Constipation
Joint pain
Blurry vision
The Correct Answer is D
Answer: D. Blurry vision
Rationale: Blurry vision, along with yellow-green halos around lights, is a sign of digoxin toxicity that can occur when the serum level of the drug exceeds 2 ng/mL. Other signs of digoxin toxicity include nausea, vomiting, anorexia, confusion, arrhythmias, and bradycardia. Tinnitus, constipation, and joint pain are not related to digoxin toxicity.
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Related Questions
Correct Answer is ["B","C","H"]
Explanation
These findings indicate that the client may have severe acute pancreatitis, which can lead to systemic complications such as hypovolemia, shock, hypocalcemia, respiratory failure, and multiorgan failure.
Mental confusion and cold, clammy skin may suggest hypovolemia and shock due to fluid shifts from inflammation and necrosis of the pancreas.
Serum amylase and lipase levels are elevated in acute pancreatitis and reflect the extent of pancreatic damage. Respiratory status should be monitored closely as acute pancreatitis can cause pleural effusion, atelectasis, pneumonia, and acute respiratory distress syndrome (ARDS).
The nurse should also assess the client's pain, heart rate, temperature, and urine output as these are important indicators of the client's condition and response to treatment.
Correct Answer is D
Explanation
The correct answer is D.
Verify the medication three times with the medication administration record. The nurse should follow the six rights of medication administration: right client, right drug, right dose, right route, right time, and right documentation. To ensure the right drug and dose, the nurse should check the medication label against the medication administration record (MAR) three times: before removing the medication from the storage area, before preparing or measuring the medication, and before administering the medication to the client.
The nurse should also use two identifiers (such as name and date of birth) to verify the right client. The nurse should document medication administration after giving the medication, not before, to avoid errors and ensure accuracy. The nurse should administer time-critical medications within 30 minutes before or after the scheduled time, not 60 minutes.
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