A nurse is monitoring a client's lower extremity following the placement of a cast earlier in the day. Which of the following findings should the nurse identify as manifestations of compartment syndrome? (Select all that apply.)

Digoxin is a cardiac glycoside commonly used to treat heart failure and certain cardiac dysrhythmias by increasing myocardial contractility and slowing conduction through the atrioventricular node. Because it has a narrow therapeutic index, electrolyte imbalances—especially hypokalemia—can significantly increase the risk of toxicity. Potassium and digoxin compete for binding sites in cardiac tissue, so low potassium levels enhance digoxin’s effects on the myocardium. Careful monitoring is essential to detect early manifestations of toxicity and prevent life-threatening cardiac complications.

Rationale:
A. Tachycardia is not the most expected adverse effect associated with digoxin toxicity related to hypokalemia. Digoxin more commonly causes bradycardia or conduction abnormalities due to increased vagal stimulation and altered cardiac electrical activity. While some ventricular tachydysrhythmias can occur, the broader and more accurate concern is dysrhythmia development.

B. Urinary retention is not a typical adverse effect of digoxin toxicity or hypokalemia. Digoxin primarily affects cardiac conduction and gastrointestinal or neurologic function rather than bladder emptying. Therefore, this finding is unrelated to the major complications associated with decreased potassium levels during digoxin therapy.

C. Dysrhythmia is correct because hypokalemia significantly increases the risk of digoxin toxicity and abnormal cardiac conduction. In clients receiving Digoxin, low potassium enhances myocardial sensitivity to the medication, potentially causing atrial, junctional, or ventricular dysrhythmias. These conduction disturbances can become severe and life-threatening if not recognized promptly.

D. Respiratory depression is not commonly associated with digoxin therapy. This adverse effect is more characteristic of opioid or sedative overdose. Digoxin toxicity primarily affects the cardiovascular, gastrointestinal, and neurologic systems rather than directly suppressing respiratory drive.

Postoperative monitoring after transfer from the postanesthesia care unit focuses on detecting early complications related to anesthesia, pain, hypovolemia, or impaired oxygenation following a surgical procedure. A postanesthesia client is at risk for hemodynamic instability due to blood loss, fluid shifts, and residual effects of anesthetic agents. Subtle changes in vital signs, especially tachycardia, may be an early indicator of deterioration. Prompt recognition and reporting are essential to prevent progression to shock or other complications.

Rationale:
A. A respiratory rate of 16/min is within normal adult limits and does not indicate respiratory compromise. Postoperative clients are closely monitored for hypoventilation or airway obstruction, but this value reflects adequate ventilation. Therefore, it does not require reporting.

B. A blood pressure of 116/72 mm Hg is within normal range and suggests stable hemodynamic status. There are no signs of hypotension or hypertension that would indicate postoperative complications. This finding is expected after transfer from PACU.

C. A temperature of 36.3°C (97°F) is within normal limits and does not indicate infection or hypothermia requiring intervention. Mild variations in temperature can occur postoperatively due to anesthesia effects, but this value is not clinically concerning.

D. A heart rate of 110/min indicates tachycardia and should be reported because it may signal pain, hypovolemia, hypoxia, or early shock in a postoperative client. Following surgery, elevated heart rate is often an early compensatory response to decreased circulating volume or physiological stress. Further assessment is required to determine the underlying cause and initiate appropriate intervention.