Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

A. Urine culture: This will help identify the presence of any urinary tract infection (UTI) causing discomfort and burning during urination.
B. Ibuprofen 600 mg every 6 hr for mild to moderate pain: While ibuprofen can help with pain relief, it does not address the potential underlying urinary tract infection, so it's important to address the infection first.
C. Obtain provider prescription for phenazopyridine: Phenazopyridine is a urinary analgesic that can provide relief from the pain and discomfort associated with UTIs.
D. Vaginal culture: The client's symptoms are related to discomfort and burning upon urination, suggesting a urinary tract issue rather than a vaginal issue. Therefore, a vaginal culture may not be relevant in this context.
E. Obtain provider prescription for antibiotics: If a urinary tract infection is suspected based on the client's symptoms and urine culture results, antibiotics may be needed to treat the infection.

Digoxin is a medicine used to treat various heart conditions, including heart failure and irregular heartbeat1. It is important to follow the doctor’s instructions carefully when giving digoxin to your child, as the dosage and timing may vary depending on your child’s age, weight, and medical condition.

Out of the four statements you provided, only one is correct. The correct statement is:

d. “Have your child drink a small glass of water after swallowing the medication.”

This statement is correct because drinking water after taking digoxin can help prevent stomach upset and ensure proper absorption of the medicine.

The other three statements are incorrect and should not be followed. Here are the reasons why:

a. “You can add the medication to a half-cup of your child’s favorite juice.”

This statement is incorrect because adding digoxin to juice or other liquids can alter the concentration and effectiveness of the medicine4. You should give digoxin to your child by mouth with or without food, using a marked measuring spoon or medicine cup. If you are using the liquid form of digoxin, you can give a small squirt of the medicine inside the cheek and let your child swallow it before giving more.

b. “Repeat the dose if your child vomits within 1 hour after taking the medication.”

This statement is incorrect because repeating the dose of digoxin can increase the risk of overdose and side effects4. Digoxin has a narrow therapeutic range, which means that too much or too little of the medicine can be harmful. If your child vomits within 1 hour after taking digoxin, do not give another dose and continue with the normal dose amount at the next scheduled time4. If your child vomits frequently or has signs of overdose, such as nausea, drowsiness, confusion, vision changes, or irregular heartbeat, call your doctor or poison control center immediately.

c. “Limit your child’s potassium intake while she is taking this medication.”

This statement is incorrect because limiting your child’s potassium intake can actually worsen the effects of digoxin6. Digoxin works by affecting the levels of sodium and potassium in the heart cells, which helps regulate the heart rhythm and contractility. However, low potassium levels can make digoxin more toxic and increase the risk of arrhythmias6. Therefore, you should not restrict your child’s potassium intake unless instructed by your doctor6. You should also avoid giving your child foods or supplements that are high in fiber, as they can interfere with the absorption of digoxin. Some examples of high-fiber foods are bran, psyllium, and some fruits and vegetables