A nurse is caring for a newly admitted patient who will receive Digoxin to treat cardiac dysrhythmia.
The patient takes hydrochlorothiazide and reports regular use of OTC laxatives.
Before administering the first dose of Digoxin, the nurse will review the patient’s electrolyte levels with careful attention to which electrolytes?

Choice A rationale

Reassuring the client without addressing the persistent cough would not be appropriate as it may signal a need for a different medication. The ACE inhibitor captopril can cause a bothersome, persistent cough in some patients due to increased bradykinin levels.

Choice B rationale

Instructing the patient to stop the medication immediately is not advised without consulting the healthcare provider. While the cough is a known side effect, stopping the medication abruptly may lead to unmanaged hypertension.

Choice C rationale

Scheduling an appointment with the provider to discuss changing to an angiotensin II receptor blocker (ARB) is appropriate. ARBs do not typically cause a persistent cough, making them a suitable alternative for patients who experience this side effect with ACE inhibitors.

Choice D rationale

Instructing the patient to go to the emergency room immediately is unnecessary as the persistent cough is a common side effect of ACE inhibitors and not an emergency situation. Emergency action is warranted for symptoms of angioedema, such as swelling of the face or throat.

Choice A rationale

Vitamin E is an antioxidant and is not indicated to counteract the effects of warfarin. It does not have a role in reversing anticoagulation or managing bleeding. High doses of Vitamin E can actually interfere with clotting and potentially exacerbate bleeding.

Choice B rationale

Protamine Sulfate is an antidote for heparin, not warfarin. It works by neutralizing the effects of heparin, which is an anticoagulant that acts quickly to prevent clot formation. Warfarin works differently and requires a different antidote for its anticoagulant effect.

Choice C rationale

Calcium Gluconate is not an antidote for warfarin. It is typically used in cases of hypocalcemia and can stabilize cardiac membranes in hyperkalemia but has no effect on reversing warfarin-induced anticoagulation or bleeding.

Choice D rationale

Vitamin K is the correct antidote for warfarin. It counteracts the anticoagulant effects by promoting the synthesis of clotting factors that warfarin inhibits. Administering Vitamin K is standard practice in reversing the effects of warfarin and managing bleeding complications.