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
Explanation
Diuretics are medicines that help the kidneys get rid of excess water and salt, which can ease the symptoms of heart failure, such as breathlessness and swelling.However, diuretics may also lower the blood pressure by reducing the blood volume and the cardiac output. This can cause symptoms such as dizziness, fatigue, or fainting.Hypotension is defined as a systolic blood pressure lower than 90 mmHg or a diastolic blood pressure lower than 60 mmHg.
Choice A is wrong because fluid retention is the opposite of what diuretics do. Diuretics increase the urine output and decrease the fluid accumulation in the body.
Choice C is wrong because hyperglycemia is not a common side effect of diuretics. Hyperglycemia is a condition where the blood sugar level is too high.Diuretics may affect the blood sugar level in some cases, but usually not significantly.
Choice D is wrong because diarrhea is not a typical side effect of diuretics.
Diarrhea is a condition where the stool is loose and watery.Diuretics may cause some gastrointestinal discomfort, such as nausea or cramps, but not diarrhea.
Normal ranges for blood pressure are 120/80 mmHg for systolic/diastolic in healthy adults, and 140/90 mmHg or higher for hypertension.Normal ranges for blood sugar are 70-100 mg/dL for fasting glucose, and less than 140 mg/dL for postprandial glucose.
Correct Answer is C
Explanation
Phenazopyridine hydrochloride (Pyridium) is a urinary tract analgesic that can relieve the pain, burning, and discomfort caused by infection or irritation of the urinary tract.However, it can also cause some side effects, one of which is changing the color of bodily secretions to reddish orange. This is due to the excretion of the drug in the urine, saliva, sweat, and tears.The color change is harmless and usually disappears when the drug is stopped.
Choice A is wrong because phenazopyridine does not change bodily secretions to alkaline.In fact, it may interfere with the urine test that measures acidity (pH) and glucose.
Choice B is wrong because phenazopyridine does not change bodily secretions to pinkish.However, some other drugs, such as rifampin and doxorubicin, may cause urine to turn red or pink.
Choice D is wrong because phenazopyridine does not change bodily secretions to black.However, some other drugs, such as metronidazole and nitrofurantoin, may cause urine to turn brown or dark yellow.
Some other common side effects of phenazopyridine include headache, dizziness, indigestion, and stomach pain.Some serious side effects include skin itching, interference with the oxygen-carrying capacity of red blood cells, hemolytic anemia, and renal and hepatic toxicity.
These problems are more common in people who have existing kidney problems or take more than recommended.If you experience any of these symptoms, stop taking phenazopyridine hydrochloride and talk to a healthcare provider right away.
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