A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?

A toddler who has vomited 2 times in the last hour

A toddler who has a digoxin level of 1.2 ng/mL (0.8 to 2 ng/mL)

A toddler who has an apical pulse of 100/min

A toddler who has a potassium level of 4.0 mEq/L (3.4 to 4.7 mEq/L)

Answer and Explanation

The Correct Answer is A

Vomiting can lead to decreased absorption of digoxin, potentially resulting in subtherapeutic levels and inadequate therapeutic effect. The plan of care should be revised to address the vomiting and consider alternative routes of administration or doses.

A digoxin level within the therapeutic range indicates adequate drug absorption and effectiveness.

An apical pulse of 100/min is within the expected range for toddlers and does not necessarily require a revision of the plan of care related to digoxin therapy.

A potassium level within the normal range is desirable and does not necessarily require a revision of the plan of care related to digoxin therapy.

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Correct Answer is C

Explanation

A. Examining the child for skin irritation at the cast edges is important to prevent complications but may not be the priority compared to monitoring for signs of impaired circulation or compartment syndrome.
B. Restricting the child's strenuous activities for 3 days is important for preventing damage to the cast, but it is not as urgent as monitoring for potential complications.
C. Monitoring for pallor or swelling in the child's affected hand is the priority to assess for impaired circulation or compartment syndrome, which are potential complications of cast application.
D. Using a hair dryer on a cool setting to relieve itching is a helpful tip but is not as urgent as monitoring for signs of impaired circulation.

A. Administer amphotericin B IV. B. Apply lidocaine ointment topically. C. Initiate contact isolation precautions. D. Report the disease to the state health department.

Correct Answer is C

Explanation

A. Amphotericin B is an antifungal medication and is not indicated for impetigo, which is a bacterial skin infection.
B. Lidocaine ointment is a local anesthetic and is not indicated for the treatment of impetigo.
C. Impetigo is highly contagious, and contact isolation precautions should be initiated to prevent its spread within the hospital setting.
D. Reporting the disease to the state health department may be necessary for surveillance purposes, but the immediate priority is to implement infection control measures.

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A nurse is caring for a group of toddlers receiving digoxin therapy. For which of the following toddlers should the nurse revise the plan of care?

Nursing Test Bank

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