A nurse is preparing to administer digoxin 5 mg PO to a client. The amount available is digoxin 0.5 mg/tablet. How many tablets should the nurse administer? (Round the answer to the nearest whole number, Use leading zero if it applies. Do not use a trailing zero.)

A) Apply pressure to the client’s nasolacrimal duct after instillation:
Applying gentle pressure to the nasolacrimal duct after administering an ophthalmic medication is a recommended practice. This action prevents the medication from draining into the nasopharynx, reducing the risk of systemic absorption and minimizing potential side effects. It also helps ensure that the medication stays localized in the eye for maximum therapeutic effect. This technique is especially important for medications like eye drops that could otherwise be absorbed systemically, such as those for glaucoma treatment.

B) Clean the client's eye from the outer canthus to the inner canthus before instillation:
The correct procedure for cleaning the eye prior to instilling ophthalmic medication is to clean from the inner canthus (near the nose) to the outer canthus (toward the temple). This technique avoids dragging debris from the outer eye toward the sensitive inner corner and helps prevent introducing contaminants into the eye. Cleaning from outer to inner canthus could potentially push debris toward the tear ducts and further irritate the eye.

C) Ask the client to tightly squeeze their eyes shut after the instillation:
Asking the client to tightly squeeze their eyes shut after instillation is not recommended. Squeezing the eyes shut can increase intraocular pressure and may actually force the medication out of the eye, reducing its effectiveness. Instead, the client should be encouraged to gently close their eyes and avoid blinking excessively. This allows the medication to stay in contact with the eye for a longer period.

D) Instill the ophthalmic medication directly on the client's cornea:
Instilling ophthalmic medication directly on the cornea is not recommended. The correct technique is to instill the medication into the conjunctival sac, which is the space between the lower eyelid and the eyeball. Instilling the medication directly onto the cornea could lead to irritation, discomfort, or damage to the sensitive corneal surface, and it would not allow the medication to be absorbed as intended.

A) Potassium level 3 mEq/L:
A potassium level of 3 mEq/L is below the normal range (which is typically 3.5-5.0 mEq/L) and represents hypokalemia. Potassium is crucial for normal muscle and nerve function, including cardiac function. Low potassium levels can lead to dangerous arrhythmias, muscle weakness, and cardiac arrest if not addressed promptly. This is the priority value because hypokalemia can be life-threatening and requires immediate attention from the healthcare provider to correct the imbalance.

B) BUN 9.5 mg/dl:
A BUN (blood urea nitrogen) level of 9.5 mg/dL is within the normal reference range for most adults (typically 7-20 mg/dL). While an abnormal BUN level could indicate kidney dysfunction or dehydration, this value is not immediately concerning and does not represent a critical finding that requires urgent attention.

C) Creatinine 0.4 mg/dl:
A creatinine level of 0.4 mg/dL is below the normal range (usually around 0.6-1.2 mg/dL), which might indicate low muscle mass or a transient decrease in kidney function. However, a low creatinine level is generally not as urgent or concerning as an elevated level, and it does not typically require immediate intervention

D) Sodium 135 mEq/L:
A sodium level of 135 mEq/L is slightly below the normal range (135-145 mEq/L), indicating mild hyponatremia. Although this can be concerning if the drop is acute or symptomatic (e.g., causing confusion, seizures, or lethargy), a mild decrease in sodium is not immediately life-threatening unless it worsens rapidly.