Which administration strategy can a patient implement to reduce flushing, the most common adverse effect of niacin therapy?

Digibind is the trade name forantidigoxin, which is an antibody made up of anti-digoxin immunoglobulin fragments.It is thespecific antidoteto digoxin toxicity, which can occur even when the serum digoxin concentration is within the therapeutic range.Digoxin toxicity causes anorexia, nausea, vomiting, neurological symptoms and arrhythmias.

Choice A, Protamine sulfate, is wrong because it is the antidote for heparin overdose, not digoxin toxicity.

Protamine sulfate reverses the anticoagulant effect of heparin by binding to it and forming a stable complex.

Choice B, Acetylcysteine, is wrong because it is the antidote for acetaminophen overdose, not digoxin toxicity.

Acetylcysteine replenishes glutathione, which is depleted by acetaminophen metabolites that cause hepatotoxicity.

Choice D, Vitamin K, is wrong because it is the antidote for warfarin overdose, not digoxin toxicity.

Vitamin K restores the synthesis of clotting factors that are inhibited by warfarin.

Normal ranges for serum digoxin concentration are 0.6 to 1.2 nanomol/L (0.5 to 0.9 nanograms/mL) for heart failure and unknown for atrial fibrillation without heart failure.

Normal ranges for serum potassium level are 3.5 to 5.0 mmol/L and for serum magnesium level are 0.7 to 1.0 mmol/L.

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.