The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min.
What should the nurse do next?
Withhold the dose and notify the health care provider.
Notify the health care provider and monitor the patient’s vital signs.
Recheck the pulse, making sure to count for 1 full minute.
Administer the dose.
The Correct Answer is A
Digoxin is a medication that can help the heart pump more blood and slow down the heart rate in certain conditions, such as heart failure and atrial fibrillation. However, digoxin has a narrow therapeutic range, which means that too much or too little of it can be harmful. The therapeutic range of digoxin levels in the blood is 0.5-2 ng/mL, and the toxic level is >2.4 ng/mL. Digoxin should be held if the resting apical pulse of an infant is <90 bpm, an older child is <70 bpm, or an adult is <60 bpm. A pulse of 48/min in an adult is too low and could indicate digoxin toxicity, which can cause life-threatening arrhythmias. Therefore, the nurse should withhold the dose and notify the health care provider immediately.
Choice B is wrong because notifying the health care provider and monitoring the patient’s vital signs are not enough.
The nurse should also withhold the dose to prevent further exposure to digoxin.
Choice C is wrong because rechecking the pulse, making sure to count for 1 full minute, is not necessary. The nurse should already have counted the pulse for 1 full minute before administering digoxin, as per standard procedure.
Choice D is wrong because administering the dose could worsen the patient’s condition and increase the risk of digoxin toxicity and arrhythmias.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["B","C"]
Explanation
The nurse should contact the provider and ask the patient if they are feeling light headed or dizzy.
Choice A is wrong because administering the medication could worsen the patient’s condition.Furosemide is a diuretic that can cause dehydration, electrolyte imbalance, and hypotension.The patient already has a low serum potassium level of 2.8 mEq/L, which is below the normal range of 3.5 to 5.0 mEq/L.Giving furosemide could lower the potassium level further and increase the risk of cardiac arrhythmias.The patient also has a significant drop in blood pressure from lying to sitting position, which indicates orthostatic hypotension.Giving furosemide could lower the blood pressure more and cause dizziness, fainting, or falls.
Choice D is wrong because encouraging the patient to get up quickly and walk around could also cause dizziness, fainting, or falls due to orthostatic hypotension.The patient should be advised to change positions slowly and carefully, and to avoid activities that require alertness until their blood pressure stabilizes.
Choice E is wrong because holding the medication without contacting the provider could delay the appropriate treatment for the patient’s fluid retention.The nurse should notify the provider of the patient’s vital signs, laboratory results, and symptoms, and follow their orders regarding the medication dosage or alternative therapy.
Correct Answer is A
Explanation
Terazosin is a medication that belongs to the class of alpha-adrenergic blockers, which relax the muscles in the prostate and bladder neck, making it easier to urinate.It also lowers blood pressure by relaxing the veins and arteries, allowing blood to flow more easily.Therefore, terazosin can cause dizziness or fainting, especially when getting up from a sitting or lying position.To prevent this, the patient should rise slowly and avoid standing for long periods or becoming overheated.
Choice B is wrong because terazosin is not a cure for benign prostatic hyperplasia (BPH), but a symptom reliever.Stopping the medication may cause the urinary problems to return or worsen.
The patient should continue taking terazosin as prescribed by the doctor, unless advised otherwise.
Choice C is wrong because decreasing fluid intake may increase the risk of dehydration, urinary tract infections, bladder stones, and kidney problems.
The patient should drink enough fluids to stay hydrated and flush out the urinary system.
Choice D is wrong because grapefruit juice may interact with terazosin and increase its blood levels, leading to more side effects such as low blood pressure, drowsiness, or headache.
The patient should avoid drinking grapefruit juice while taking terazosin, or consult the doctor before doing so.
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