Which drug increases the excretion of water and sodium by the kidneys, reducing blood volume and blood pressure?

Digoxin (Lanoxin) is a cardiac glycoside that is used to improve the contractility of the heart and slow down the heart rate in patients with chronic heart failure. However, digoxin has a narrow therapeutic range and can cause toxicity if the dose is too high or if the patient has low potassium levels. A normal serum digoxin level is 0.5 to 2 ng/mL and a normal serum potassium level is 3.5 to 5 mEq/L. A low heart rate (less than 60 beats/min) is a sign of digoxin toxicity and the nurse should withhold the medication and report it to the provider. The nurse should also check the patient’s serum digoxin and potassium levels to determine if they are within normal limits.

Choice A is wrong because administering the medication as ordered could worsen the patient’s condition and increase the risk of digoxin toxicity.

Choice C is wrong because checking the patient’s serum digoxin level is not enough to prevent digoxin toxicity. The nurse should also check the patient’s serum potassium level and heart rate before giving digoxin.

Choice D is wrong because giving an additional dose of digoxin could cause a fatal overdose and lead to cardiac arrest. The nurse should never give more than the prescribed dose of digoxin without consulting the provider.

This is because metoprolol is a beta blocker, which can block the beta-2 receptors in the lungs and cause constriction of the airways.This can lead to breathing problems such as shortness of breath, cough, and wheezing. Bronchospasm is more likely to occur in people who have asthma or chronic obstructive pulmonary disease (COPD).

Choice A is wrong because tachycardia, or fast heart rate, is not an adverse effect of metoprolol. In fact, metoprolol can lower the heart rate by blocking the beta-1 receptors in the heart.A normal resting heart rate for adults ranges from 60 to 100 beats per minute (bpm).Metoprolol can cause bradycardia, or slow heart rate, which can be a serious side effect if it is too low.

Choice B is wrong because hyperglycemia, or high blood sugar, is not an adverse effect of metoprolol. Metoprolol does not affect the insulin secretion or glucose metabolism in the body.A normal blood sugar level for adults without diabetes is less than 140 mg/dL (7.8 mmol/L) two hours after eating. Metoprolol can cause hypoglycemia, or low blood sugar, in people who have diabetes and take insulin or other glucose-lowering medications.This is because metoprolol can mask the symptoms of hypoglycemia, such as palpitations and tremors.

Choice D is wrong because hyperkalemia, or high potassium, is not an adverse effect of metoprolol. Metoprolol does not affect the potassium balance in the body.

A normal blood potassium level for adults is 3.6 to 5.2 millimoles per liter (mmol/L)