A patient is being treated for heart failure. Labs: Sodium 146 meq/L, Potassium 4.2 mmol/L, Hemoglobin 10.5 gm/dL, White Blood Cells 12.2, digoxin level 0.8 ng/mL

VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4°F

What will the nurse do with the digoxin order?

Recheck heart rate in one hour

Give the digoxin as ordered

Call prescriber and ask for chest x-ray

Hold the digoxin and call the MD

Answer and Explanation

The Correct Answer is B

Choice A reason: This choice is incorrect because there is no need to recheck the heart rate in one hour before giving the digoxin. The client's apical heart rate is within the normal range (60 to 100 beats per minute) and does not indicate bradycardia (slow heart rate), which is a sign of digoxin toxicity. The nurse should check the apical heart rate for one full minute before giving the digoxin and withhold the dose if the heart rate is below 60 beats per minute.

Choice B reason: This choice is correct because the client's digoxin level is within the therapeutic range (0.5 to 2.0 ng/mL) and does not indicate digoxin toxicity or underdosing. The client's vital signs and labs are also stable and do not indicate any adverse effects of digoxin. Digoxin is a cardiac glycoside that improves the contractility and efficiency of the heart and helps to control the heart rate and rhythm in clients with heart failure. The nurse should give the digoxin as ordered and monitor the client's response and digoxin level.

Choice C reason: This choice is incorrect because there is no indication for a chest x-ray for this client. A chest x-ray is a diagnostic test that can show the size and shape of the heart and lungs and detect any abnormalities, such as fluid accumulation, infection, or tumors. The client's symptoms and labs do not suggest any pulmonary complications or worsening of heart failure that would require a chest x-ray. The nurse should follow the provider's orders and protocols for chest x-ray indications.

Choice D reason: This choice is incorrect because there is no reason to hold the digoxin and call the MD for this client. The client's digoxin level is not too high or too low and does not require dose adjustment or discontinuation. The client's vital signs and labs are also normal and do not indicate any signs of digoxin toxicity or adverse effects. Holding the digoxin could cause the client's heart failure to worsen or cause arrhythmias. The nurse should only hold the digoxin and call the MD if the client has signs of digoxin toxicity, such as nausea, vomiting, visual disturbances, confusion, or bradycardia. .

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Correct Answer is ["150 mL\/hr"]

Explanation

To calculate the IV pump rate for the 0.9% sodium chloride 1,200 mL IV to infuse over 8 hours, we can use the following formula:

IV pump rate (mL/hr) = Total volume (mL) / Time (hr)

Using the given values:

Total volume = 1,200 mL

Time = 8 hours

Plugging these values into the formula:

IV pump rate = 1,200 mL / 8 hr

IV pump rate = 150 mL/hr

So, the nurse should set the IV pump to deliver 150 mL/hr to infuse the 1,200 mL of 0.9% sodium chloride over 8 hours.

Correct Answer is ["1.1 mL"]

Explanation

To calculate the amount of cefazolin that the nurse should add to the 50 mL of 0.9% sodium chloride, we can use the following steps:

Calculate the amount of cefazolin needed to prepare the solution:

The concentration to be achieved is 225 mg/mL.

The required dose is 250 mg.

Calculate the volume of cefazolin needed:

250 mg ÷ 225 mg/mL = 1.111... mL

Rounded to the nearest tenth, the nurse should add 1.1 mL of cefazolin to the 50 mL of 0.9% sodium chloride.

Therefore, the nurse should add 1.1 mL of cefazolin to the 50 mL of 0.9% sodium chloride to prepare the solution for IV administration.

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A patient is being treated for heart failure. Labs: Sodium 146 meq/L, Potassium 4.2 mmol/L, Hemoglobin 10.5 gm/dL, White Blood Cells 12.2, digoxin level 0.8 ng/mL VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4°F What will the nurse do with the digoxin order?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer 0.9% sodium chloride 1,200 mL IV to infuse over 8 hr. The nurse should set the IV pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["150 mL\/hr"]

Explanation

Correct Answer is ["1.1 mL"]

Explanation

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A patient is being treated for heart failure. Labs: Sodium 146 meq/L, Potassium 4.2 mmol/L, Hemoglobin 10.5 gm/dL, White Blood Cells 12.2, digoxin level 0.8 ng/mL

VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4°F

What will the nurse do with the digoxin order?