A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Hemoglobin

Creatinine

Blood urea nitrogen

Potassium

Answer and Explanation

The Correct Answer is A

A.   Hemoglobin levels are important for assessing oxygen-carrying capacity of the blood. While anemia can affect tissue oxygenation and exacerbate symptoms in heart failure, it is not directly related to the risk of digoxin toxicity.
B.   Creatinine levels are used to assess kidney function. Impaired kidney function can affect the clearance of digoxin from the body, potentially increasing the risk of toxicity. However, potassium levels have a more direct impact on the risk of digoxin toxicity.
C.   BUN levels are also used to assess kidney function. Similar to creatinine, impaired kidney function can affect digoxin clearance, but potassium levels are more directly related to the risk of digoxin toxicity.
D.   Potassium levels are critical because hypokalemia (low potassium) can predispose the client to digoxin toxicity. Digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in cardiac cells. When potassium levels are low, digoxin can bind more readily to these pumps, leading to increased toxicity and potentially life-threatening arrhythmias such as ventricular tachycardia or ventricular fibrillation.

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Correct Answer is D

Explanation

A. Hypophosphatemia refers to low levels of phosphate in the blood. In prerenal AKI, phosphate levels are typically normal or even elevated due to reduced kidney function and impaired phosphate excretion. Therefore, hypophosphatemia is not expected in prerenal AKI.
B. Hypernatremia refers to high levels of sodium in the blood. In prerenal AKI, sodium levels can be elevated due to reduced kidney function and impaired ability to excrete sodium. This occurs because the kidneys play a crucial role in regulating sodium balance. Therefore, hypernatremia is a possible electrolyte imbalance in prerenal AKI.
C. Hypercalcemia refers to high levels of calcium in the blood. In prerenal AKI, calcium levels are usually normal or decreased due to various factors, including reduced renal excretion of calcium. Therefore, hypercalcemia is not typically seen in prerenal AKI.
D. Hyperkalemia refers to high levels of potassium in the blood. In prerenal AKI, hyperkalemia is a common electrolyte imbalance. Normally, the kidneys play a critical role in potassium excretion. Reduced kidney function in prerenal AKI can lead to impaired potassium excretion, resulting in elevated potassium levels in the blood.

A. Spontaneous bleeding B. Infection C. Oliguria D. Hyperactive deep tendon reflexes

Correct Answer is A

Explanation

A. Thrombocytopenia (low platelet count) predisposes the client to spontaneous bleeding. This can manifest as petechiae (small red or purple spots on the skin), purpura (larger areas of purple discoloration), mucosal bleeding (such as nosebleeds or bleeding gums), or internal bleeding (such as gastrointestinal or intracranial bleeding). Monitoring for signs of bleeding is essential to promptly intervene and prevent complications.
B. While infections can occur in any client, a low platelet count does not directly predispose the client to infection. Thrombocytopenia primarily affects hemostasis rather than immune function.
C. Oliguria refers to decreased urine output, typically less than 400 mL/day in adults. It is not directly related to thrombocytopenia but may occur in conditions affecting kidney function or fluid balance.
D. Hyperactive deep tendon reflexes can indicate neurological conditions or electrolyte imbalances but are not associated with thrombocytopenia.

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A nurse is planning to administer digoxin to a client who has heart failure. Which of the following laboratory results is the priority for the nurse to review prior to administering the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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