A nurse is reporting a client's laboratory tests to the provider to obtain a prescription for the client's daily warfarin. Which of the following laboratory tests should the nurse plan to report to obtain the prescription for the warfarin?

Digoxin is a medicine used to treat various heart conditions, including heart failure and irregular heartbeat1. It is important to follow the doctor’s instructions carefully when giving digoxin to your child, as the dosage and timing may vary depending on your child’s age, weight, and medical condition.

Out of the four statements you provided, only one is correct. The correct statement is:

d. “Have your child drink a small glass of water after swallowing the medication.”

This statement is correct because drinking water after taking digoxin can help prevent stomach upset and ensure proper absorption of the medicine.

The other three statements are incorrect and should not be followed. Here are the reasons why:

a. “You can add the medication to a half-cup of your child’s favorite juice.”

This statement is incorrect because adding digoxin to juice or other liquids can alter the concentration and effectiveness of the medicine4. You should give digoxin to your child by mouth with or without food, using a marked measuring spoon or medicine cup. If you are using the liquid form of digoxin, you can give a small squirt of the medicine inside the cheek and let your child swallow it before giving more.

b. “Repeat the dose if your child vomits within 1 hour after taking the medication.”

This statement is incorrect because repeating the dose of digoxin can increase the risk of overdose and side effects4. Digoxin has a narrow therapeutic range, which means that too much or too little of the medicine can be harmful. If your child vomits within 1 hour after taking digoxin, do not give another dose and continue with the normal dose amount at the next scheduled time4. If your child vomits frequently or has signs of overdose, such as nausea, drowsiness, confusion, vision changes, or irregular heartbeat, call your doctor or poison control center immediately.

c. “Limit your child’s potassium intake while she is taking this medication.”

This statement is incorrect because limiting your child’s potassium intake can actually worsen the effects of digoxin6. Digoxin works by affecting the levels of sodium and potassium in the heart cells, which helps regulate the heart rhythm and contractility. However, low potassium levels can make digoxin more toxic and increase the risk of arrhythmias6. Therefore, you should not restrict your child’s potassium intake unless instructed by your doctor6. You should also avoid giving your child foods or supplements that are high in fiber, as they can interfere with the absorption of digoxin. Some examples of high-fiber foods are bran, psyllium, and some fruits and vegetables

The correct answer is Choice A.

Choice A rationale: “What are the voices telling you?” This is the priority response because it directly addresses the client’s immediate concern. The nurse is acknowledging the client’s experience and seeking to understand more about it. This can help the nurse assess the potential for harm to the client or others, as the voices may be instructing the client to engage in dangerous behaviors.

Choice B rationale: “Have you taken your medication today?” While medication adherence is important in managing schizophrenia, this response does not address the client’s immediate concern about hearing voices. It may also come across as dismissive of the client’s experience.

Choice C rationale: “I realize the voices are real to you, but I don’t hear anything.” This response validates the client’s experience, but it does not gather further information about what the voices are saying, which is crucial for assessing safety.

Choice D rationale: “How long have you been hearing the voices?” While this question is relevant for understanding the client’s history and the progression of their illness, it is not the priority response. The immediate concern should be what the voices are saying to assess for potential harm.