A nurse is educating a client who has a new prescription for digoxin. Which of the following statements should the nurse make?

A. “Taking an HMG CoA reductase inhibitor”: HMG CoA reductase inhibitors, also known as statins, are used to lower cholesterol levels. While they can interact with many medications, they do not specifically predispose a client to developing digoxin toxicity.

B. “Having a prolapsed mitral valve”: A prolapsed mitral valve can lead to mitral valve regurgitation and potentially heart failure, but it does not specifically predispose a client to developing digoxin toxicity.

C. “Taking a high-ceiling diuretic”: This is the correct answer. High-ceiling diuretics, also known as loop diuretics, can cause electrolyte imbalances, particularly low potassium levels (hypokalemia). Digoxin toxicity is more likely to occur when potassium levels are low, as digoxin and potassium compete for the same binding sites in the body. Therefore, taking a high-ceiling diuretic can predispose a client to developing digoxin toxicity.

D. “Having a 10-year history of COPD”: While chronic obstructive pulmonary disease (COPD) can exacerbate heart failure symptoms, it does not specifically predispose a client to developing digoxin toxicity.

A) Have the client take the medication on an empty stomach to avoid interactions:
This action may not be appropriate as taking medications on an empty stomach can sometimes increase the risk of adverse effects or decrease medication effectiveness. The decision to take medication with or without food depends on the specific medication and its instructions. It does not address the broader scope of potential interactions with other medications or foods.

B) Consult a drug reference guide for possible interactions:
This is the most appropriate action. Drug reference guides, such as the Physicians' Desk Reference (PDR) or online databases, provide comprehensive information about medications, including potential interactions with other drugs and foods. Consulting a reliable drug reference guide allows the nurse to make informed decisions about medication administration and identify any potential interactions that may affect the client's safety and treatment outcomes.

C) Ask another nurse if they are aware of potential interactions:
While seeking advice from colleagues can sometimes be helpful, relying solely on another nurse's knowledge may not provide comprehensive information about potential interactions. Additionally, the accuracy and reliability of the information obtained from another nurse may vary. Consulting a drug reference guide or other reliable resources is a more systematic approach to ensuring medication safety.

D) Check the client's medical record for medication and food interactions:
While the client's medical record may contain valuable information about their current medications and medical history, it may not always include detailed information about potential interactions with specific foods. Additionally, relying solely on the medical record may overlook recent changes in the client's medication regimen or newly prescribed medications. Consulting a drug reference guide provides more comprehensive and up-to-date information about potential interactions.