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 A
Explanation
Intermittent claudication is a condition in which leg pain is produced upon increased activity and ischemia to tissues, but then the pain is reduced with rest. This is because the blood flow to the leg muscles is insufficient to meet the increased demand during exercise, but adequate at rest.Intermittent claudication is a common symptom of peripheral artery disease (PAD), which is a narrowing of the arteries that supply blood to the legs.
Choice B, sporadic ischemia, is wrong because it is not a specific medical term for a condition that causes leg pain.
Ischemia means reduced blood flow to a part of the body, which can cause pain, but it can be caused by various factors and affect different organs.
Choice C, angina, is wrong because it is a term for chest pain caused by reduced blood flow to the heart, not the legs.
Angina can also be triggered by physical activity and relieved by rest, but it is not related to PAD or leg ischemia.
Choice D, restless leg syndrome, is wrong because it is a condition that causes an uncomfortable urge to move the legs, usually at night or when lying down.
Restless leg syndrome does not cause pain or ischemia in the legs, and it is not improved by rest.It is thought to be related to a problem with the nervous system or iron deficiency.
Correct Answer is C
Explanation
Exposure to cold temperatures should be avoided by the patient with peripheral vascular disease such as Raynaud’s disease.
This is because cold temperatures can trigger vasospasm, which is a sudden narrowing of the small arteries in the fingers or toes, limiting blood flow and causing pain, numbness and color changes.
Choice A is wrong because wearing warm mitten gloves can help prevent or reduce the severity of Raynaud’s attacks by keeping the hands warm.
Choice B is wrong because wearing socks can also help protect the feet from cold exposure and prevent or reduce Raynaud’s attacks.
Choice D is wrong because engaging in regular exercise can improve blood circulation and reduce the frequency and duration of Raynaud’s attacks.However, exercise should be done with caution and proper clothing to avoid injury or frostbite to the affected areas.
Normal ranges for peripheral vascular disease are not applicable, as it is a condition that affects the blood vessels and not a specific blood test or measurement.
However, some tests that can help diagnose peripheral vascular disease or its underlying causes are blood pressure measurement, ankle-brachial index, Doppler ultrasound, angiography, blood tests for cholesterol, glucose, clotting factors and inflammatory markers.
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