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Difficulty: MediumPharmacological Therapies

A practical nurse (PN) is preparing to administer scheduled morning doses of oral digoxin and furosemide to a client diagnosed with heart failure. Which actions must the PN take to ensure safe medication administration? Select all that apply.

  1. Auscultate the client's apical pulse for one full minute.Answer
  2. B
    Proceed with administering the medications if the most recent serum potassium level is 2.8 mEq/L.
  3. Review the client's most recent serum potassium laboratory results.Answer
  4. D
    Adjust the furosemide dose based on the client's morning weight and urine output.
  5. Ask the client to state their name and verify their date of birth on the identification band.Answer
  6. F
    Confirm the client's identity by verifying their assigned room and bed number.

Answer

The practical nurse must auscultate the apical pulse for one full minute, review the most recent serum potassium results, and verify the client's identity using their name and date of birth.
Safe administration of this specific medication combination requires evaluating the apical pulse because digoxin slows the heart rate, and reviewing serum potassium because furosemide can cause hypokalemia, which in turn increases the risk of digoxin toxicity. Furthermore, standard medication safety mandates using two proper client identifiers, such as the client's name and date of birth.

Step-by-Step Solution

1
Analyze the prescribed medications and their physiological implications.
The client is receiving digoxin, which affects the heart rate, and furosemide, which promotes fluid and potassium loss.
Understanding the pharmacokinetics and adverse effects of these medications dictates the necessary pre-administration clinical assessments.
2
Determine the specific safety parameters for these medications.
An apical pulse check is mandatory for digoxin. A serum potassium level check is required because furosemide-induced hypokalemia precipitates digoxin toxicity.
These targeted assessments ensure the medications are safe to administer at the current time and prevent life-threatening complications.
3
Apply general medication administration rights and scope of practice limitations.
The PN must use two acceptable client identifiers (name and date of birth). Adjusting doses or ignoring critical lab values is unsafe and outside the PN scope of practice.
Strict adherence to the rights of medication administration and professional boundaries prevents medication errors and client harm.

Key Concept

Safe administration of concurrent digoxin and furosemide requires assessing the apical pulse, monitoring serum potassium to prevent toxicity, and strictly adhering to the rights of medication administration within the practical nurse scope of practice.
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Topics

Pharmacological Therapies

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