A practical nurse is caring for a client with congestive heart failure who is scheduled to receive a morning dose of oral digoxin. The client's morning laboratory results show a serum potassium level of () and a serum digoxin level of (). The client's apical pulse is . During the morning assessment, the client reports new-onset severe nausea and seeing yellow halos around the lights in the room. Which action should the practical nurse take first?
- AAdminister the digoxin as prescribed because the apical pulse is greater than and the serum drug level is within the therapeutic range.
- BConvert the oral digoxin prescription to an intravenous push dose to bypass the gastrointestinal tract and prevent vomiting.
- Withhold the digoxin dose and immediately report the client's symptoms and laboratory values to the supervising registered nurse.Cevap
- DBypass barcode scanning and use the client's room number to quickly administer the medication before the nausea worsens.
Cevap
The practical nurse must withhold the digoxin dose and immediately report the client's symptoms and laboratory values to the supervising registered nurse.
The correct action is to withhold the dose and notify the RN. The client's potassium level of indicates hypokalemia. Low potassium increases the heart's sensitivity to digoxin, significantly elevating the risk of toxicity even when the serum digoxin level () falls within the normal therapeutic range (). Furthermore, the client's nausea and visual disturbances (yellow halos) are classic clinical indicators of digoxin toxicity. The practical nurse must hold the medication and escalate these critical findings.
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Anahtar Kavram
Digoxin Toxicity and Hypokalemia