A nurse in a provider's office is monitoring blood electrolytes for four clients who take digoxin.
Which of the following electrolyte values increases a client's risk for digoxin toxicity?
Potassium 3.0 mEq/L.
Calcium 9.2 mg/dL.
Sodium 140 mEq/L.
Magnesium 2.2 mg/dL.
The Correct Answer is A
This is because low potassium levels (hypokalemia) increase the sensitivity of the heart to digoxin and can lead to toxicity even with normal serum digoxin levels. Digoxin inhibits the sodium-potassium pump on the cardiac cells, which causes potassium to accumulate outside the cells. Low potassium levels in the blood create a larger gradient for potassium to move out of the cells, which enhances the effect of digoxin and can cause arrhythmias.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range (8.5 to 10.2 mg/dL) and does not increase the risk of digoxin toxicity. However, high calcium levels (hypercalcemia) can potentiate the effects of digoxin and cause toxicity.
Choice C is wrong because sodium 140 mEq/L is within the normal range (135 to 145 mEq/L) and does not increase the risk of digoxin toxicity. However, high sodium levels (hypernatremia) can reduce the binding of digoxin to the sodium-potassium pump and decrease its efficacy.
Choice D is wrong because magnesium 2.2 mg/dL is within the normal range (1.7 to 2.4 mg/dL) and does not increase the risk of digoxin toxicity. However, low magnesium levels (hypomagnesemia) can increase the sensitivity of the heart to digoxin and cause toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Lisinopril belongs to the class of drugs calledangiotensin-converting enzyme (ACE) inhibitors.ACE inhibitors work by blocking the enzyme that converts angiotensin I to angiotensin II, a hormone that causes blood vessels to narrow and raise blood pressure.By inhibiting this enzyme, ACE inhibitors relax and widen the blood vessels, lower blood pressure, and improve blood flow to the heart and kidneys.
Choice B.Candesartan is wrong because it belongs to the class of drugs calledangiotensin II receptor blockers (ARBs).ARBs work by blocking the action of angiotensin II on its receptors, preventing it from causing blood vessel constriction and high blood pressure.ARBs are similar to ACE inhibitors in their effects, but they do not affect the enzyme or the level of bradykinin, a peptide that can cause cough and angioedema as side effects of ACE inhibitors.
Choice C.Metoprolol is wrong because it belongs to the class of drugs calledbeta blockers.Beta blockers work by blocking the effects of adrenaline and other hormones that stimulate the heart and blood vessels, causing them to beat slower and with less force.Beta blockers lower blood pressure and reduce the workload on the heart.
Choice D.Amlodipine is wrong because it belongs to the class of drugs calledcalcium channel blockers.Calcium channel blockers work by blocking the entry of calcium into the muscle cells of the heart and blood vessels, causing them to relax and dilate.Calcium channel blockers lower blood pressure and improve blood flow to the heart.
Normal ranges for blood pressure vary depending on age, gender, and other factors, but generally, a systolic blood pressure (the top number) of less than 120 mmHg and a diastolic blood pressure (the bottom number) of less than 80 mmHg are considered normal for adults.A blood pressure of 130/80 mmHg or higher is considered high and may require treatment with medication.
Correct Answer is D
Explanation
Angiotensin receptor blockers (ARBs) are a class of drugs that block the action of angiotensin II, a hormone that causes blood vessels to constrict and raise blood pressure. Examples of ARBs include losartan, valsartan, candesartan, and irbesartan.ARBs are used to treat hypertension, heart failure, and chronic kidney disease.
Choice A is wrong because calcium channel blockers (CCBs) are a class of drugs that prevent calcium from entering the cells of the heart and blood vessels, causing them to relax and lower blood pressure.
Examples of CCBs include amlodipine, diltiazem, verapamil, and nifedipine.CCBs are used to treat hypertension, angina, and arrhythmias.
Choice B is wrong because beta blockers are a class of drugs that reduce the heart rate and force of contraction, lowering the cardiac output and blood pressure.
Examples of beta blockers include atenolol, metoprolol, propranolol, and bisoprolol.Beta blockers are used to treat hypertension, angina, heart failure, and arrhythmias.
Choice C is wrong because platelet inhibitors are a class of drugs that prevent platelets from clumping together and forming blood clots.
Examples of platelet inhibitors include aspirin, clopidogrel, ticagrelor, and prasugrel.Platelet inhibitors are used to prevent or treat cardiovascular events such as heart attack or stroke.
Choice E is wrong because ACE inhibitors are a class of drugs that inhibit the enzyme that converts angiotensin I to angiotensin II, reducing the production of this vasoconstrictor hormone.
Examples of ACE inhibitors include lisinopril, enalapril, ramipril, and captopril.ACE inhibitors are used to treat hypertension, heart failure, and chronic kidney disease.
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