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Soru

Zorluk: OrtaPharmacological Therapies

An older adult resident in a long-term care facility is prescribed daily oral digoxin and hydrochlorothiazide. During the morning assessment, the resident reports a sudden onset of poor appetite, nausea, and severe fatigue. The electronic health record indicates a morning serum potassium level of 3.0 mEq/L3.0\text{ mEq/L}. Which action is most appropriate for the practical nurse to take?

  1. Withhold the scheduled digoxin dose and promptly report the findings to the supervising registered nurse.Cevap
  2. B
    Administer the scheduled medications because a potassium level of 3.0 mEq/L is within the expected normal range.
  3. C
    Document the resident's symptoms as a routine age-related change and continue with the daily care plan.
  4. D
    Administer the dose after confirming the resident's identity by stating their name and observing for an affirmative nod.

Cevap

Withhold the scheduled digoxin dose and promptly report the findings to the supervising registered nurse.
The correct action is to withhold the medication and escalate the findings. The resident is exhibiting signs of digoxin toxicity (nausea, anorexia, fatigue), which is closely linked to the abnormally low potassium level of 3.0 mEq/L3.0\text{ mEq/L}. Hydrochlorothiazide is a potassium-wasting diuretic that frequently causes hypokalemia. The practical nurse's priority is client safety, which requires holding the dangerous medication and notifying the registered nurse for further assessment.

Adım Adım Çözüm

1
Analyze the resident's clinical symptoms.
The resident has a sudden onset of poor appetite, nausea, and severe fatigue.
These are classic early signs of digoxin toxicity, which must be closely monitored in older adults.
2
Evaluate the laboratory values provided in the context of the prescribed medications.
The serum potassium level is 3.0 mEq/L3.0\text{ mEq/L}.
A normal potassium level is 3.5 to 5.0 mEq/L3.5\text{ to }5.0\text{ mEq/L}. A level of 3.0 mEq/L3.0\text{ mEq/L} indicates hypokalemia (likely caused by the hydrochlorothiazide), which significantly increases the heart's sensitivity to digoxin and the risk of toxicity.
3
Determine the appropriate nursing action based on the practical nurse scope of practice.
The nurse must withhold the digoxin and notify the registered nurse.
Administering the medication could cause severe harm. The practical nurse must recognize the abnormal findings, ensure client safety by holding the drug, and escalate the situation to the registered nurse or provider for medical evaluation.

Anahtar Kavram

Digoxin Toxicity and Hypokalemia Management
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Konular

Pharmacological Therapies

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