The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately?
Reference Range:
Sodium [Adult 136 to 145 mEq/L (136 to 145 mmol/L)]
Digoxin level (0.8 to 2.0 ng/mL (0.6 to 13 nmol/L)]
Potassium (K+) [Adult: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]
Digoxin level of 1.1 ng/mL (1.4 nmol/L).
Creatinine level of 0.8 mg/dL (70.72 μmol/L).
Potassium level of 3.2 mEq/L (3.2 mmol/L).
Sodium level of 135 mEq/L (135 mmol/L).
The Correct Answer is C
A. Digoxin level of 1.1 ng/mL (1.4 nmol/L):
A digoxin level of 1.1 ng/mL is within the therapeutic range (0.8 to 2.0 ng/mL). While it is important to monitor digoxin levels, this value does not indicate an immediate concern.
B. Creatinine level of 0.8 mg/dL (70.72 μmol/L):
A creatinine level of 0.8 mg/dL is within the normal range (0.5 to 1.1 mg/dL) and does not indicate any renal impairment or immediate issue.
C. Potassium level of 3.2 mEq/L (3.2 mmol/L):
A potassium level of 3.2 mEq/L is below the normal range (3.5 to 5.0 mEq/L). Hypokalemia can increase the risk of digoxin toxicity and arrhythmias, making this an urgent issue that should be reported to the healthcare provider immediately.
D. Sodium level of 135 mEq/L (135 mmol/L):
A sodium level of 135 mEq/L is slightly below the normal range (136 to 145 mEq/L), but it is not as critical as a significantly abnormal potassium level in the context of digoxin use. While it should be monitored, it is less urgent compared to the potassium level.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Notify the healthcare provider of lethargy:
Cimetidine can cause side effects such as confusion and lethargy, especially in the elderly or those with renal impairment. Reporting these symptoms to the healthcare provider is important for proper management and potential adjustment of treatment.
B. Decrease cigarette use to a pack per day:
This statement indicates a misunderstanding of the impact of smoking on peptic ulcer disease. Smoking can exacerbate ulcer symptoms and interfere with healing. The nurse should instruct the client to ideally quit smoking altogether rather than just reducing the amount.
C. Monitor for any signs of sexual dysfunction:
Cimetidine can cause sexual dysfunction, including decreased libido and erectile dysfunction. The client should be aware of this potential side effect and report any such issues to their healthcare provider for further evaluation and management.
D. Take the medication an hour after antacids:
Cimetidine should not be taken simultaneously with antacids as this can interfere with its absorption. Taking cimetidine an hour after antacids is a correct approach to avoid interaction and ensure effective medication action.
Correct Answer is B
Explanation
A. Monitor the client's serum electrolytes:
Amlodipine, a calcium channel blocker, primarily affects blood pressure and not directly electrolyte levels. Monitoring electrolytes is more relevant for medications that affect electrolyte balance, such as diuretics or certain antihypertensives.
B. Measure the client's blood pressure:
Amlodipine is used to treat hypertension and angina by relaxing blood vessels. The primary measure of its effectiveness is the reduction in blood pressure. Therefore, measuring the client’s blood pressure is crucial to assess whether the medication is effectively managing hypertension.
C. Review the client's intake and output:
While monitoring intake and output is important for assessing fluid balance and kidney function, it is not the primary method for evaluating the effectiveness of amlodipine in controlling blood pressure.
D. Note the client's serum calcium levels:
Amlodipine affects calcium channels but does not directly influence serum calcium levels significantly. Serum calcium levels are not used to assess the effectiveness of amlodipine in treating hypertension or angina.
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