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Soru

Zorluk: OrtaPharmacological Therapies

An older adult client with a history of heart failure is prescribed a daily dose of oral digoxin. Before providing the medication, the practical nurse notes an apical pulse of 74 beats/minute and a newly resulted serum potassium level of 2.8 mEq/L (2.8 mmol/L). Which action should the practical nurse take first?

  1. Defer the medication administration and immediately notify the registered nurse.Cevap
  2. B
    Administer the medication as prescribed and document the findings in the electronic health record.
  3. C
    Proceed to verify the client's identity using two unique identifiers before giving the tablet.
  4. D
    Reduce the medication dose by half to compensate for the abnormal electrolyte level.

Cevap

The practical nurse should defer the digoxin administration and notify the registered nurse because the client is experiencing hypokalemia.
The correct action is to withhold the medication and escalate the finding. A normal serum potassium level is between 3.5 and 5.0 mEq/L. A level of 2.8 mEq/L indicates severe hypokalemia. Low potassium levels make the heart muscle more sensitive to digoxin, which can easily lead to digitalis toxicity and fatal dysrhythmias, even if the actual blood level of digoxin is within a normal therapeutic range. The nurse must protect the client by holding the dose and reporting the lab value.

Adım Adım Çözüm

1
Evaluate the client's apical pulse.
The pulse is 74 beats/minute.
Digoxin is typically withheld if the apical pulse is below 60 beats/minute in an adult. In this case, the heart rate is acceptable for administration.
2
Evaluate the client's laboratory results.
The serum potassium level is 2.8 mEq/L (normal range is typically 3.5 to 5.0 mEq/L).
Identifying abnormal lab values is a critical component of safe medication administration.
3
Correlate the laboratory finding with the prescribed medication.
Hypokalemia increases the myocardium's sensitivity to digoxin, leading to a high risk of toxicity and dangerous dysrhythmias.
Understanding drug-electrolyte interactions prevents adverse pharmacological events.
4
Determine the appropriate nursing intervention.
The nurse must withhold the medication and escalate the finding to the supervising registered nurse or provider.
Acting within the practical nurse scope requires reporting critical abnormalities before proceeding with a potentially harmful intervention.

Anahtar Kavram

Digoxin Administration and Hypokalemia
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Konular

Pharmacological Therapies

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