Based on a client’s serum digoxin level, the client is diagnosed with digoxin toxicity. Which action should the nurse expect to implement?

Choice A reason: Administering potassium is not the primary action for treating digoxin toxicity. While hypokalemia can exacerbate digoxin toxicity, the initial step is to assess and stabilize the patient’s overall condition, including acid-base and electrolyte balance. Potassium administration may be considered if hypokalemia is present, but it is not the first-line treatment.

Choice B reason: Cardioversion is not typically used to treat digoxin toxicity. Digoxin toxicity can cause various arrhythmias, but the treatment focuses on stabilizing the patient and addressing the toxicity itself2. Cardioversion may be considered in life-threatening arrhythmias, but it is not the primary intervention.

Choice C reason: Checking acid-base and electrolyte values is crucial in managing digoxin toxicity. Digoxin toxicity can lead to electrolyte imbalances, particularly hyperkalemia, which can be life-threatening. Assessing and correcting these imbalances is essential for stabilizing the patient and preventing further complications.

Choice D reason: Giving digoxin by another route to slow absorption is not an appropriate action. The primary treatment for digoxin toxicity involves stopping the medication and administering digoxin-specific antibody fragments (Fab) if necessary. These antibodies bind to digoxin, neutralizing its effects and allowing for its excretion.

Choice A reason:

Rinsing the mouth after each use of an inhaler is a recommended practice, especially for inhalers containing corticosteroids, to prevent oral thrush and other side effects. Although ipratropium is not a corticosteroid, rinsing the mouth can still help reduce any potential irritation or unpleasant taste.

Choice B reason:

Storing the medication at room temperature is appropriate for most inhalers, including ipratropium2. This ensures the medication remains effective and safe to use. It is important to keep the inhaler away from extreme temperatures and direct sunlight.

Choice C reason:

Attaching a spacer device to the inhaler can be beneficial, especially for patients who have difficulty coordinating the timing of inhalation with the activation of the inhaler. A spacer helps ensure that more medication reaches the lungs rather than being deposited in the mouth or throat.

Choice D reason:

Priming the inhaler with 7 pumps is excessive. Typically, ipratropium inhalers require priming with only 2 to 4 sprays before the first use or if the inhaler has not been used for a few days. Over-priming can waste medication and may indicate that the client needs additional instruction on proper inhaler use.