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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Correct Answer is B

Explanation

A. A quiet, restful environment:
While a quiet and restful environment may be beneficial for general comfort, it does not specifically address the visual issues related to the use of mydriatic medications. Mydriatics cause pupil dilation, which can increase sensitivity to light, so a dimly lit room is more appropriate for managing light sensitivity.

B. A dimly lit room:
A dimly lit room is best for a client receiving mydriatic medication because mydriatics cause pupil dilation, which can lead to increased sensitivity to light and difficulty with bright environments. Reducing light exposure helps manage these symptoms and improve comfort.

C. A warm room temperature:
While maintaining a comfortable room temperature is important, it does not specifically address the visual discomfort caused by mydriatic medications. The primary concern here is light sensitivity, which is better managed with dim lighting rather than room temperature.

D. Cool, humidified air:
Cool, humidified air can be helpful for certain respiratory conditions or comfort but does not directly address the issue of light sensitivity associated with mydriatic medication use. The focus should be on managing light exposure rather than air quality.

A. Explore what the client means by the drug "is not working." B. Determine if the client is taking the medication before meals. C. Evaluate the client for signs of dyskinesia. D. Ask if the client's morning voids are dark colored.

Correct Answer is A

Explanation

A. Explore what the client means by the drug "is not working":
The first step in addressing the client's concern is to understand their perception of how the medication is performing. This involves exploring their specific symptoms, any changes they've noticed, and their expectations of the medication. This understanding will help guide further assessment and intervention.

B. Determine if the client is taking the medication before meals:
Carbidopa-levodopa is typically recommended to be taken on an empty stomach to optimize absorption. While this is important for effective medication use, addressing the client's perception of the drug's effectiveness takes priority to identify whether there is an issue with their treatment regimen or if other factors are influencing their response.

C. Evaluate the client for signs of dyskinesia:
Dyskinesia, or involuntary movements, can be a side effect of long-term use of carbidopa-levodopa, but evaluating for these signs should follow the initial exploration of the client's concerns. If the client believes the medication is ineffective, it’s crucial first to clarify what symptoms they are experiencing before assessing for specific side effects.

D. Ask if the client's morning voids are dark colored:
Dark-colored urine is not directly related to the effectiveness of carbidopa-levodopa. This assessment is less relevant compared to understanding the client's overall experience with the medication and symptoms. Addressing the client’s concern about the medication’s effectiveness should be the priority.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning the home care of a client who is receiving a mydriatic medication. Which environment is best for this client?

Correct Answer is B

Explanation

The nurse is assessing a client who was recently diagnosed with Parkinson's disease and is taking carbidopa-levodopa. The client is concerned that the medication is not working. Which intervention should the nurse implement first?

Correct Answer is A

Explanation

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