A nurse cares for a patient recovering from mechanical valve replacement surgery. The patient asks, "Why will I need to take anticoagulants for the rest of my life?" What is the best response by the nurse?

Choice A reason: Administering 2 tablets of digoxin 0.125 mg would provide the correct dosage of 0.25 mg. However, given the client's heart rate of 54/min, administering the medication could further lower the heart rate, which can be dangerous. The nurse should withhold the medication and notify the physician.

Choice B reason: Withholding the digoxin dose for decreased heart rate is the correct action. Digoxin is used to slow down the heart rate and strengthen heart contractions. A heart rate of 54/min is considered bradycardia (slow heart rate), and administering digoxin could exacerbate the bradycardia, leading to potential complications such as heart block or severe arrhythmias. Therefore, it is critical to withhold the medication and inform the physician of the client's current heart rate.

Choice C reason: Administering one tablet of digoxin 0.125 mg would not provide the full prescribed dose of 0.25 mg. More importantly, the client's low heart rate makes it unsafe to administer any dose of digoxin at this time.

Choice D reason: Withholding the digoxin dose for elevated blood pressure is not appropriate. Although the client has elevated blood pressure (144/96), the more immediate concern is the low heart rate. Digoxin affects heart rate more than blood pressure, and the risk of exacerbating bradycardia takes precedence.

Choice A reason: An increased albumin level, while noteworthy, is not typically an urgent finding to communicate immediately following paracentesis. Albumin levels can fluctuate for various reasons, and elevated levels do not generally indicate a critical issue requiring immediate intervention.

Choice B reason: A normal platelet count is a good sign, indicating that the patient has an adequate number of platelets for blood clotting and wound healing. This finding does not indicate an urgent need to notify the healthcare provider immediately.

Choice C reason: A 2-cm area of serous drainage on the dressing is relatively small and expected after a procedure like paracentesis. It suggests that the site is draining some fluid, which is normal post-procedure. While it should be monitored, it does not necessitate urgent communication unless it worsens or there are signs of infection.

Choice D reason: A heart rate of 122 beats/min is tachycardia and can indicate several potential complications, including hypovolemia (low blood volume) due to the large fluid removal, infection, or other stressors on the patient's body. This finding is the most critical to communicate to the healthcare provider promptly as it may require immediate intervention to address the underlying cause and stabilize the patient.