A client with atrial fibrillation receives a prescription for a loading dose of digoxin 0.5 mg PO. The medication is available in 125 mcg tablets. How many tablets should the nurse administer? (Enter numerical value only.)

A. Irrigate the nasogastric tube with water may be necessary if the tube is clogged, but it does not address the immediate concern of the client choking. The priority is ensuring the client’s airway is clear.

B. Elevate the head of bed 45 degrees is a useful intervention for reducing aspiration risk, but it does not address the immediate need to clear the airway when the client is choking. Elevating the head of the bed could be helpful after the airway is cleared.

C. Review the advanced directive document is important for understanding the client’s wishes, but the immediate priority is addressing the choking. The nurse should focus on clearing the airway first, then review the advanced directive as appropriate.

D. Perform oropharyngeal suctioning is the most appropriate action. The client is vomiting and choking, which suggests a risk of airway obstruction. Oropharyngeal suctioning will help clear the airway and prevent aspiration, which is the priority in this situation.

A. Compare muscle strength bilaterally is not the most immediate concern. Although muscle weakness is a potential sign of hypokalemia, the priority is assessing for cardiac complications, as potassium imbalances can cause life-threatening arrhythmias.

B. Determine apical heart rate and rhythm is the most important intervention. A potassium level of 2.5 mEq/L is dangerously low and can lead to life-threatening cardiac arrhythmias. The nurse should assess the heart rate and rhythm to detect any abnormalities such as bradycardia, tachycardia, or irregular rhythms, which are common in hypokalemia.

C. Observe color and amount of urine is not the priority. While renal function is important, the immediate concern in this case is the potential for severe cardiac complications due to the low potassium level.

D. Assess strength of deep tendon reflexes is important for detecting signs of hypokalemia, but it is secondary to assessing the heart, as potassium imbalances primarily affect cardiac function.