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.
Potassium 4.8 mEq/L.
Calcium 10.3 mg/dL.
The Correct Answer is A
This is because digoxin inhibits the Na-K-ATPase pump on the membrane of cardiac cells, which can cause extracellular potassium levels to rise. Hypokalemia (low potassium) caused by large dosages of diuretics may result in digoxin toxicity even at low serum digoxin levels. Digoxin toxicity can cause gastrointestinal, constitutional, and/or cardiovascular symptoms, as well as ECG changes such as signs of increased automaticity and atrioventricular node blockade.
Choice B is wrong because calcium 9.2 mg/dL is within the normal range of 8.5 to 10.5 mg/dL. Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.
Choice C is wrong because potassium 4.8 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.
Hyperkalemia (high potassium) can also increase the risk of digoxin toxicity, but this is not the case here.
Choice D is wrong because calcium 10.3 mg/dL is within the normal range of 8.5 to 10.5 mg/dL. Hypercalcemia (high calcium) can increase sensitivity to digoxin effects and lead to toxicity even with a lower concentration of serum digoxin, but this is not the case here.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Dry mouth is a common adverse effect of anticholinergic agents used to treat overactive bladder syndrome (OAB).Anticholinergic agents prevent involuntary contractions of the bladder detrusor muscle by blocking the action of acetylcholine, a neurotransmitter that stimulates the muscle.However, anticholinergics are not tissue specific, and they also affect other parts of the body where acetylcholine is involved, such as the salivary glands, the gastrointestinal tract, and the eyes.
Choice B is wrong because restlessness is not a typical side effect of anticholinergic agents.In fact, anticholinergics can cause sedation and drowsiness in some people.
Choice C is wrong because increased salivation is the opposite of what anticholinergics do.Anticholinergics reduce the secretion of saliva, causing dry mouth.
Choice D is wrong because diarrhea is also the opposite of what anticholinergics do.Anticholinergics slow down the movement of the gastrointestinal tract, causing constipation.
Some other possible adverse effects of anticholinergic agents include blurred vision, urinary retention, confusion, memory impairment, and increased risk of dementia and mortality.
Therefore, these drugs should be used with caution and under medical supervision.
Correct Answer is C
Explanation
Urecholine is the brand name of bethanechol, a drug that belongs to the class of cholinergics, genitourinary.
Choice A is wrong because adrenergic drugs are those that activate the sympathetic nervous system, which is responsible for the fight-or-flight response.Adrenergic drugs can cause relaxation of the bladder and urinary retention, not contraction and emptying.
Choice B is wrong because anticholinergic drugs are those that block the action of acetylcholine, a neurotransmitter that mediates the parasympathetic nervous system, which is responsible for the rest-and-digest response.Anticholinergic drugs can also cause relaxation of the bladder and urinary retention, not contraction and emptying.
Choice D is wrong because adrenergic blockers are those that inhibit the action of adrenergic receptors, which are activated by adrenergic drugs or by the natural neurotransmitters norepinephrine and epinephrine.Adrenergic blockers can have various effects on the bladder depending on the type and location of the receptors they block, but they are not used to treat urinary retention.
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