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).

Answer and Explanation

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.

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Free Nursing Study Resources

Correct Answer is C

Explanation

A. Avoid taking the medication on an empty stomach:
While it can be helpful to take lithium with food to minimize gastrointestinal upset, it is not the primary instruction for lithium use. The most important aspect of lithium therapy involves fluid balance and monitoring.

B. Keep medication fliers for frequent review and reference:
While reviewing medication information is useful, it is not as critical as maintaining appropriate fluid intake and monitoring for side effects specific to lithium.

C. Maintain a fluid intake of 1500 to 3000 mL per day:
This is crucial because lithium levels can be affected by changes in fluid balance. Inadequate fluid intake can lead to dehydration, which can increase lithium levels and the risk of toxicity. Therefore, maintaining adequate hydration is essential for safe lithium use.

D. Report fluctuations in weight to the healthcare provider:
While fluctuations in weight can be relevant for overall health monitoring, the more immediate concern with lithium therapy is to maintain proper fluid intake and monitor for signs of toxicity or dehydration.

Correct Answer is ["200"]

Explanation

Calculations:

Total volume of the IV bag = 200 mL

Infusion time = 1 hour

To calculate the infusion rate in mL/hr, we use the formula:

Infusion rate (mL/hr) = Total volume (mL) / Infusion time (hours)

Infusion rate (mL/hr) = 200 mL / 1 hour = 200 mL/hr

Therefore, the nurse should program the infusion pump to deliver 200 mL/hr.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing medication teaching to a client with bipolar disorder who receives a prescription for lithium carbonate. Which instruction should the nurse emphasize with the client?

Correct Answer is C

Explanation

A client receives a prescription for ciprofloxacin 400 mg intravenously (IV) every 12 hours to be infused over an hour. The IV bag contains ciprofloxacin 400 mg in dextrose 5% in water (DW) 200 mL. The nurse should program the infusion pump to deliver how many mL/hr? (Enter numerical value only.)

Correct Answer is ["200"]

Explanation

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