The nurse prepares to administer digoxin 0.125 mg PO to a client who has chronic heart failure. The laboratory report reveals a digoxin level of 2.5 mg/mL. Which nursing action is most appropriate at this time?

Choice A reason: Admission blood pressure is 110/70 is not the information that the nurse must report to the health care provider prior to the procedure. This is a normal blood pressure reading for an adult client and does not indicate any contraindication or complication for the cardiac angiogram.

Choice B reason: Client has multiple food and drug allergies is the information that the nurse must report to the health care provider prior to the procedure. This is a critical information that may affect the choice of contrast agent, medications, or equipment used for the cardiac angiogram. The nurse should identify the specific allergens and the type and severity of the allergic reactions that the client has experienced in the past.

Choice C reason: Pedal pulses are 1+ bilaterally is not the information that the nurse must report to the health care provider prior to the procedure. This is a low-normal finding for the strength of the peripheral pulses and does not indicate any significant vascular impairment or obstruction. The nurse should document and monitor the pedal pulses, but not necessarily report them.

Choice D reason: Client is slightly anxious is not the information that the nurse must report to the health care provider prior to the procedure. This is a common and expected emotional response for a client who is undergoing an invasive diagnostic test and does not require any immediate intervention. The nurse should provide reassurance and education to the client and address any concerns or questions that they may have.

Choice A reason: This is the correct answer. Tremors and twitching are signs of hypomagnesemia, which is a low level of magnesium in the blood. Magnesium is a mineral that is involved in many enzymatic reactions and neuromuscular functions. A low magnesium level can cause hyperexcitability of the nerves and muscles, leading to involuntary movements and spasms. Alcoholism can cause hypomagnesemia by reducing the absorption and increasing the excretion of magnesium.

Choice B reason: Positive Chvostek's sign is not a sign of hypomagnesemia, but of hypocalcemia, which is a low level of calcium in the blood. Calcium is another mineral that is important for the function of nerves and muscles. A low calcium level can cause tetany, which is a condition of sustained muscle contraction. Chvostek's sign is a test that involves tapping the facial nerve in front of the ear and observing for a twitching of the facial muscles. A positive Chvostek's sign indicates hypocalcemia, not hypomagnesemia.

Choice C reason: Decreased deep tendon reflexes are not a sign of hypomagnesemia, but of hypermagnesemia, which is a high level of magnesium in the blood. A high magnesium level can cause hyporeflexia, which is a reduced or absent response to stimuli. Magnesium has a sedative effect on the nerves and muscles, and can inhibit the transmission of impulses. Hypermagnesemia can be caused by excessive intake or impaired excretion of magnesium.

Choice D reason: Polyuria and flank pain are not signs of hypomagnesemia, but of kidney problems, such as infection, stones, or failure. Polyuria is the production of abnormally large amounts of urine, and flank pain is the pain in the side or back below the ribs. These symptoms can indicate damage or inflammation of the kidneys, which can affect the balance of fluids and electrolytes in the body. Hypomagnesemia does not directly cause polyuria or flank pain, but it can be a result of kidney dysfunction.