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
The Correct Answer is D
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Metformin is an oral antidiabetic medication commonly used to manage type 2 diabetes mellitus. It can cause a rare but serious side effect called lactic acidosis, especially in situations where there is impaired kidney function or when the drug interacts with contrast dye used in procedures like cardiac catheterization.
B. Carvedilol is a beta-blocker used to manage hypertension and heart failure. It does not have a significant interaction with contrast dye that would increase the risk of AKI.
C. Atorvastatin is a statin medication used to lower cholesterol levels. It does not interact with contrast dye in a way that increases the risk of AKI.
D. Nitroglycerin is a vasodilator used to relieve angina symptoms. It does not interact with contrast dye in a way that increases the risk of AKI.
Correct Answer is C
Explanation
A. Postoperative ileus and significant drainage via an NG tube are more likely to lead to electrolyte losses rather than elevated levels. Elevated magnesium levels are less common and typically associated with conditions such as renal failure or excessive magnesium intake.
B. Calcium levels can be affected by gastrointestinal losses, including drainage via an NG tube. Significant fluid loss can lead to hemoconcentration, potentially causing a relative increase in calcium levels initially. However, prolonged fluid loss can lead to overall depletion of electrolytes, including calcium.
C. When fluids are lost through the NG tube, potassium, which is an intracellular electrolyte, can be lost in large amounts. Prolonged drainage can lead to hypokalemia (decreased potassium levels), which can result in muscle weakness, cardiac dysrhythmias, and other serious complications.
D. Elevated sodium levels (hypernatremia) are more commonly associated with dehydration or excessive sodium intake rather than drainage via an NG tube. In this scenario, sodium levels are less likely to be affected compared to potassium.
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