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 C
Explanation
Nitrates are a class of drugs that help to widen the blood vessels and increase blood flow to the heart muscle, which reduces the chest pain or discomfort caused by angina.Nitrates can be taken as a mouth spray or tablets that dissolve under the tongue during an angina attack, or as a preventive measure before physical activity.
Choice A is wrong because fatty oxidase enzyme inhibitors are not a real class of drugs.
Fatty acid oxidation is a process that breaks down fats for energy, and it is not related to angina treatment.
Choice B is wrong because beta adrenergic blockers are not the main class of drugs for angina treatment, although they can be used to prevent angina attacks by slowing down the heart rate and reducing the blood pressure.
Beta blockers block the effects of epinephrine (adrenaline) on the heart and blood vessels, which reduces the oxygen demand of the heart.
Choice D is wrong because statins are not used to treat angina attacks, but to lower the cholesterol levels in the blood and prevent plaque buildup in the arteries.
Statins can help reduce the risk of heart attacks and strokes in people with angina, but they do not relieve angina symptoms.
Correct Answer is D
Explanation
This is because nitroglycerin patches can cause tolerance if they are used continuously, which reduces their effectiveness in preventing angina attacks. Removing the patch each evening allows the body to restore its sensitivity to the drug.
Choice A is wrong because nitroglycerin patches should be applied every 24 hours, not every 48 hours.
Applying a new patch every 48 hours would result in inadequate blood levels of the drug and increased risk of angina.
Choice B is wrong because nitroglycerin patches should not be cut in half or altered in any way.
Cutting the patch would compromise the integrity of the drug delivery system and could lead to unpredictable or excessive doses of the drug.
Choice C is wrong because nitroglycerin patches should not be taken off for 30 minutes if a headache occurs.
Headache is a common side effect of nitroglycerin due to its vasodilating action, but it usually subsides with continued use.
Taking off the patch for 30 minutes could increase the risk of angina by interrupting the steady blood levels of the drug.
The nurse should advise the client to take an analgesic such as acetaminophen for headache relief.
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