A nurse is preparing to administer a dose of digoxin to a client who is experiencing heart failure. Which of the following actions should the take prior to administering this medication?

Auscultate the client's lung sounds

Check the client's weight.

Check the client's apical pulse.

Obtain the client's oxygen saturation

Answer and Explanation

The Correct Answer is C

A. Auscultate the client's lung sounds: While lung sounds are important to assess in clients with heart failure, auscultating lung sounds is not directly required before administering digoxin. The immediate concern with digoxin is its effect on heart rate and rhythm.

B. Check the client's weight: Monitoring weight is important in heart failure management to assess fluid retention, but weight measurement is not necessary immediately prior to administering a dose of digoxin.

C. Check the client's apical pulse: Before giving digoxin, it is critical to assess the client's apical pulse for one full minute. If the pulse is below a specified rate (60 beats/min for adults), the dose may need to be withheld and the provider notified due to the risk of digoxin-induced bradycardia.

D. Obtain the client's oxygen saturation: Oxygen saturation is important in evaluating respiratory function, but it is not a priority action before administering digoxin. The primary safety check is heart rate assessment.

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Correct Answer is A

Explanation

A. Discontinue use of electronics 30 min before bedtime: The use of electronics before bedtime can disrupt the body's natural sleep cycle by suppressing melatonin production. Stopping electronic use at least 30 minutes before bed promotes relaxation and better sleep quality.

B. Drink a cup of coffee 1 hr before bedtime: Caffeine is a stimulant that can interfere with falling asleep and maintaining deep sleep. Consuming coffee close to bedtime would likely worsen sleep disturbances rather than help.

C. Consume a meal 1 hr before bedtime: Eating a large meal close to bedtime can cause discomfort, indigestion, and difficulty falling asleep. Light snacks are acceptable, but heavy meals should be avoided before sleeping.

D. Exercise 1 hr before bedtime: Vigorous exercise shortly before bedtime can increase adrenaline and body temperature, making it harder to fall asleep. Exercise is better scheduled earlier in the day to support restful sleep.

A. Nonmaleficence B. Autonomy C. Beneficence D. Justice

Correct Answer is B

Explanation

A. Nonmaleficence: Nonmaleficence refers to the obligation to do no harm and to avoid causing injury. While this principle is always important in healthcare, the central issue in this scenario involves respecting the client's decision-making rights rather than directly preventing harm.

B. Autonomy: Autonomy is the ethical principle that supports a client's right to make their own healthcare decisions, even if those decisions differ from the wishes of others, including family members. Respecting the 18-year-old client's choice to decline surgery honors their legal and moral right to self-determination.

C. Beneficence: Beneficence involves taking actions that promote the well-being and best interests of the client. While advocating for the surgery could be seen as promoting beneficence, the nurse’s primary ethical duty in this situation is to respect the client’s independent decision.

D. Justice: Justice is concerned with fairness and the equitable distribution of healthcare resources. Although justice is a core ethical principle, it does not directly apply to an individual’s right to refuse treatment as seen in this situation.

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A nurse is preparing to administer a dose of digoxin to a client who is experiencing heart failure. Which of the following actions should the take prior to administering this medication?

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