A nurse is caring for a patient with atrial fibrillation who is on a daily regimen of digoxin. What action should the nurse take before administering this medication?

Choice A rationale

Lubricating the suction catheter tip with sterile saline is not recommended because it can introduce bacteria into the tracheostomy tube and cause infection.

Choice B rationale

Hyperventilating the patient on 100% oxygen prior to suctioning is not necessary and can cause complications such as oxygen toxicity.

Choice C rationale

Performing chest physiotherapy prior to suctioning is not typically done during tracheostomy care. Chest physiotherapy is a separate procedure that involves physical techniques to remove mucus from the respiratory tract.

Choice D rationale

Suctioning two to three times with a 60-second pause between passes is the correct action. This helps to remove secretions effectively without causing hypoxia.

Choice A rationale

Orlistat works by inhibiting the absorption of dietary fats in the body, which are then excreted in the stool. One of the side effects of this process can be changes in bowel habits, including an increase in the frequency of bowel movements and an oily discharge. Dark urine can be a sign of liver damage, which is a rare but serious side effect of orlistat. Therefore, if a patient notices their urine getting darker in color while taking orlistat, they should stop taking the medication and call their doctor immediately.

Choice B rationale

Orlistat should be taken with a meal that contains fat, not necessarily before breakfast. If a meal is missed or contains no fat, the dose of orlistat should be skipped.

Choice C rationale

Orlistat does not directly affect hunger signals or the feeling of fullness. It works in the digestive system to block about one-third of the fat in the food you eat from being digested.

Choice D rationale

While it’s important to maintain a balanced, reduced-calorie diet while taking orlistat, a no-fat diet is not recommended. Orlistat works by blocking the absorption of some of the fat from meals. If a meal contains no fat, there is no fat for orlistat to block.