The follow questions refer to the patient described below:
A 9 yr. old child with both hydrocephalus and a cardiac defect weighs 55 pounds. He requires digoxin by mouth once daily, the dose should be held if there are any symptoms of toxicity.
Pediatric maintenance dose is 5 mcg/kg daily given as a single dose. After listening to the apical rate for one full minute, you note it is only 50. Should you administer the digoxin as ordered?
NO
Just administer it without checking
instruct mom to give it
Yes
The Correct Answer is A
Digoxin is a medication commonly used to treat certain heart conditions, including some congenital heart defects. It's important to monitor the heart rate and other signs of toxicity when administering digoxin, especially in pediatric patients. Let's break down the information given:
The pediatric maintenance dose of digoxin is 5 mcg/kg daily.
The child weighs 55 pounds (approximately 25 kg).
Given these values, the total daily dose for this child would be:
Total daily dose = 5 mcg/kg × 25 kg = 125 mcg
This total daily dose is usually given as a single dose. However, the child's heart rate is noted to be only 50 beats per minute (bpm). A heart rate of 50 bpm in a child could potentially indicate bradycardia (slow heart rate), which can be a sign of digoxin toxicity. Bradycardia is a known adverse effect of digoxin, and it's important to assess for other signs of toxicity as well, such as nausea, vomiting, and changes in color vision.
In this case, it would be prudent to withhold the digoxin and assess the child further for signs of toxicity or bradycardia. The dose should not be administered until the healthcare provider is consulted and appropriate action is determined.
So, the correct answer is indeed NO. Administering the digoxin without considering the slow heart rate and the potential for toxicity could be unsafe for the child.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A) Absence of proteinuria:
Chronic glomerulonephritis often involves damage to the glomeruli in the kidneys, which can lead to the leakage of protein into the urine, resulting in proteinuria. The absence of proteinuria would be an unexpected finding in a patient with chronic glomerulonephritis. Therefore, this choice is incorrect.
B) Serum phosphorus 4.0 mg/dL (within expected reference range):
Serum phosphorus levels within the expected reference range are not directly related to chronic glomerulonephritis. While abnormalities in electrolyte levels might occur due to kidney dysfunction, serum phosphorus within the normal range is not a hallmark finding of glomerulonephritis. Therefore, this choice is incorrect.
C) Serum potassium 3.8 mEq/L (within the expected reference range):
Similar to serum phosphorus, serum potassium levels within the normal range are not specific to chronic glomerulonephritis. Kidney dysfunction can indeed affect electrolyte levels, but a serum potassium level within the normal range doesn't provide specific information about glomerulonephritis. Therefore, this choice is incorrect.
D) BUN 50 mg/dL (elevated):
Blood Urea Nitrogen (BUN) is a waste product that is filtered by the kidneys. Elevated BUN levels indicate impaired kidney function, as the kidneys are less efficient at filtering and excreting waste products. Chronic glomerulonephritis can lead to progressive kidney damage, which can result in elevated BUN levels due to decreased filtration and clearance. Therefore, an elevated BUN level is an expected finding in a patient with chronic glomerulonephritis.
Correct Answer is A
Explanation
A. "My son might complain of feeling shaky when he has a low blood glucose level."
Explanation: Correct Choice. Shaking or feeling shaky is a common symptom of low blood glucose levels, also known as hypoglycemia. When blood sugar drops too low, the body releases adrenaline, causing shaking or trembling. This response is indicative of an understanding of hypoglycemia symptoms.
B. "My son might have nausea and vomiting with hypoglycemia."
Explanation: Nausea and vomiting are not typical symptoms of hypoglycemia (low blood sugar). They are more commonly associated with hyperglycemia (high blood sugar) or other conditions. This statement is not accurate in the context of hypoglycemia.
C. "Sweating can occur with hyperglycemia."
Explanation: Sweating is more commonly associated with hypoglycemia (low blood sugar) rather than hyperglycemia (high blood sugar). When blood sugar levels drop too low, the body can respond with sweating as part of the adrenaline release. Sweating is not a typical symptom of hyperglycemia.
D. "The onset of low blood glucose usually occurs slowly."
Explanation: The onset of low blood glucose (hypoglycemia) can vary. It can occur suddenly, especially if the individual takes too much insulin or diabetes medication, leading to a rapid drop in blood sugar. The correct understanding is that the onset of low blood glucose can be rapid and not always slow.
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