The nurse is caring for a client prescribed digoxin. When assessing the client for adverse effects, the nurse should assess for which of the following signs and symptoms? (Select All that Apply.)

numbness in extremities

fatigue

Shortness of breath

anorexia

Chest pain

Confusion

Answer and Explanation

Correct Answer : B,C,D,E,F

A. Numbness in extremities: Numbness in extremities is not a common adverse effect of digoxin. The focus of digoxin monitoring is primarily on cardiovascular and gastrointestinal effects.

B. Fatigue: Fatigue is a common adverse effect of digoxin and can indicate toxicity or overdose. Clients taking digoxin should be monitored for increased fatigue or weakness.

C. Shortness of breath: Shortness of breath can occur as an adverse effect of digoxin toxicity, particularly if it leads to pulmonary congestion or heart failure exacerbation.

D. Anorexia: Anorexia, or loss of appetite, can be a gastrointestinal adverse effect of digoxin. Clients may experience nausea, vomiting, or anorexia, which can contribute to weight loss and electrolyte imbalances.

E. Chest pain: Chest pain can be a sign of digoxin toxicity, especially if it is associated with other symptoms such as shortness of breath or palpitations. It is essential to evaluate any chest pain in a client taking digoxin.

F. Confusion: Confusion or changes in mental status can occur with digoxin toxicity, particularly in older adults. Clients should be monitored for signs of confusion, delirium, or other cognitive changes.

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Correct Answer is B

Explanation

A. Administer aspirin:

Aspirin is commonly given to patients suspected of having a heart attack because it helps to inhibit platelet aggregation and reduce the risk of further clot formation. However, the administration of aspirin typically follows the confirmation of a cardiac event through diagnostic tests like the ECG. Aspirin is not the initial priority compared to obtaining diagnostic data.

B. 12 Lead Electrocardiography (ECG):

This is the most critical and time-sensitive action because it helps to quickly assess the patient's cardiac status. A 12 Lead ECG can identify important findings such as ST-segment elevation or depression, which are indicative of acute myocardial infarction (heart attack) or other cardiac abnormalities. Early detection and intervention are crucial in improving outcomes for patients with suspected cardiac events.

C. Assess vital signs:

Vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, provide valuable information about the patient's overall condition and can help determine the severity of the cardiac event. While assessing vital signs is important, performing the ECG takes precedence due to its immediate relevance in diagnosing and managing a potential cardiac emergency.

D. Administer morphine:

Morphine may be indicated for pain relief in patients with acute coronary syndromes. However, its administration should be based on the patient's pain level, hemodynamic stability, and other factors assessed after obtaining the ECG and vital signs. Morphine administration is not the primary action within the first 10 minutes of the patient's arrival; it follows the initial assessment and diagnostic procedures.

A. I will not have to get an IV placed. B. I can eat my breakfast before the test. C. I must not drink my hot chocolate in the morning. D. I can wear the clothes I would wear to the office.

Correct Answer is C

Explanation

A. "I will not have to get an IV placed."An IV may be placed in some cases, especially if the stress test includes the use of a pharmacological agent (like adenosine or dobutamine) in place of exercise.

B. "I can eat my breakfast before the test."Clients are typically instructed to fast for at least 3 hours before the exercise stress test. Eating could interfere with accurate test results and the ability to safely exercise. The client should not eat right before the test.

C. "I must not drink my hot chocolate in the morning."Caffeine can interfere with the results of the exercise stress test by increasing heart rate and potentially masking abnormal responses to exercise. Therefore, the client should avoid caffeine (including hot chocolate) before the test.

D. "I can wear the clothes I would wear to the office."The client should wear comfortable clothing and shoes that allow for physical activity and movement, such as athletic wear. Office attire may not be suitable for the physical exertion required during the exercise stress test.

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The nurse is caring for a client prescribed digoxin. When assessing the client for adverse effects, the nurse should assess for which of the following signs and symptoms? (Select All that Apply.)

Nursing Test Bank

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