A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What will the nurse do next?
a. Administer the dose.
b. Administer the dose, and notify the prescriber.
c. Check the radial pulse for 1 full minute.
d. Withhold the dose, and notify the prescriber.
A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room with the morning medications, the patient states, “I am seeing a funny yellow color around the lights.” What is the nurse’s next action?
a. Assess the patient for symptoms of digoxin toxicity.
b. Withhold the next dose of the diuretic.
c. Administer the digoxin and diuretic together as ordered.
d. Document this finding, and reassess in 1 hour.
While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the patient?
a. Decreased blood pressure
b. Decreased heart rate
c. Decreased conduction
d. Decreased ectopic beats
A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse’s best response?
a. “It will increase your heart rate.”
b. “This drug helps to lower your potassium levels.”
c. “It helps to convert the irregular heart rhythm to a more normal rhythm.”
d. “This drug is an antidote to digoxin and will help to lower the blood levels.”
A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion?
Hypertension
Hyperkalemia
Nausea and vomiting
Cardiac dysrhythmias
A patient has a digoxin level of 1.1 ng/mL. Which interpretation by the nurse is correct?
It is below the therapeutic level.
It is within the therapeutic range.
It is above the therapeutic level.
It is at a toxic level.
The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?
Leafy green vegetables
Dairy products
Grapefruit juice
Bran muffins
In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?
Potassium level 2.8 mEq/L
Potassium level 4.9 mEq/L
Sodium level 140 mEq/L
Calcium level 10 mg/dL
The nurse administering the phosphodiesterase inhibitor milrinone (Primacor) recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?
Increased heart rate
Increased blood vessel dilation
Increased force of cardiac contractions
Increased conduction of electrical impulses across the heart
The nurse notes in a patient’s medical record that nesiritide (Natrecor) has been ordered. Based on this order, the nurse interprets that the patient has which disorder?
Atrial fibrillation
Acutely decompensated heart failure with dyspnea at rest
Systolic heart failure
Chronic, stable heart failure
When administering digoxin immune Fab (Digibind) to a patient with severe digoxin toxicity, the nurse knows that each vial can bind with how much digoxin?
0.5 mg
5 mg
5.5 mg
15 mg
A patient is in the intensive care unit and receiving an infusion of milrinone (Primacor) for severe heart failure. The prescriber has written an order for an intravenous dose of furosemide (Lasix). How will the nurse give this drug?
Infuse the drug into the same intravenous line as the milrinone.
Stop the milrinone, flush the line, and then administer the furosemide.
Administer the furosemide in a separate intravenous line
Notify the prescriber that the furosemide cannot be given at this time.
When a patient is experiencing digoxin toxicity, which clinical situation would necessitate the use of digoxin immune Fab (Digifab)? (Select all that apply.)
The patient reports seeing colorful halos around lights.
The patient’s serum potassium level is above 5 mEq/L.
The patient is experiencing nausea and anorexia.
The patient is experiencing severe sinus bradycardia that does not respond to cardiac pacing.
The patient has received an overdose of greater than 10 mg of digoxin.
The patient reports fatigue and headaches.
Which drug classes are considered first-line treatment for heart failure? (Select all that apply.)
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin II receptor blockers (ARBs)
Digoxin (cardiac glycoside)
Beta blockers
Nesiritide (Natrecor), the B-type natriuretic peptide
The medication order for a 4-year-old child reads, “Give digoxin elixir, 15 mcg/kg, PO now.” Convert the micrograms to milligrams. ______
0.015 mg
0.10 mg
.05 mg
