A nurse is caring for a client who is taking digoxin to treat heart failure. Which of the following factors predisposes this client to developing digoxin toxicity?
Taking an HMG CoA reductase inhibitor.
Having a 10-year history of COPD.
Taking a high-ceiling diuretic.
Having a prolapsed mitral valve.
The Correct Answer is C
Taking a high-ceiling diuretic predisposes this client to developing digoxin toxicity because it can cause hypokalemia (low blood potassium level), which increases the sensitivity of the heart to digoxin. Digoxin is a medicine that is used to treat heart failure or arrhythmias (abnormal heart rhythms) by increasing cardiac contractility and controlling the heart rate. Digoxin toxicity happens when there is too much digoxin in the body and it becomes harmful, causing symptoms such as nausea, vomiting, headache, confusion, vision disturbance, and irregular heartbeat.
Choice A is wrong because taking an HMG CoA reductase inhibitor (also called a statin) does not increase the risk of digoxin toxicity.
Statins are lipid-lowering medications used to prevent coronary heart disease by blocking an enzyme involved in cholesterol synthesis.
Statins do not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice B is wrong because having a 10-year history of COPD (chronic obstructive pulmonary disease) does not increase the risk of digoxin toxicity. COPD is a lung condition that causes breathing difficulties and chronic inflammation.
COPD does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Choice D is wrong because having a prolapsed mitral valve does not increase the risk of digoxin toxicity.
A prolapsed mitral valve is a condition where the valve between the left atrium and left ventricle of the heart does not close properly, allowing some blood to leak back into the atrium.
A prolapsed mitral valve does not affect the blood potassium level or the sensitivity of the heart to digoxin.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This site is preferred for peripheral IV catheter placement because it is comfortable, has good blood flow, and has a lower risk of complications than the dominant arm or the antecubital fossa.
Choice A is wrong because the dominant antecubital basilic vein is more prone to dislodgement, thrombosis, and thrombophlebitis due to frequent movement of the elbow joint.
Choice B is wrong because the nondominant dorsal venous arch is a distal site that may have poor blood flow and higher resistance to infusion. It should be avoided unless there are no other options.
Choice C is wrong because the dominant distal dorsal vein is also a distal site that may have poor blood flow and higher resistance to infusion. It should be avoided unless there are no other options.
Correct Answer is A
Explanation
Calcium gluconate is used to treat hypermagnesemia because it can help calm some symptoms such as impaired breathing, irregular heartbeat, and hypotension. Calcium also helps normalize the neuromuscular function that is affected by excess magnesium.
Choice B. Acetylcysteine is wrong because it is used to treat acetaminophen overdose and prevent kidney damage from contrast dye.
It has no role in treating hypermagnesemia.
Choice C. Flumazenil is wrong because it is used to reverse the effects of benzodiazepines, a class of sedative drugs.
It has no role in treating hypermagnesemia.
Choice D. Protamine sulfate is wrong because it is used to reverse the effects of heparin, an anticoagulant drug.
It has no role in treating hypermagnesemia.
Normal ranges for magnesium are 1.7 to 2.3 mg/dL or 0.7 to 1.1 mmol/L. Hypermagnesemia is defined as a magnesium level above 2.6 mg/dL or 1.5 mmol/L.
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