A patient is ordered to receive digoxin to treat congestive heart failure. The nurse is most concerned about which assessment finding.

RR 18 bpm

1+ pitting edema of the lower extremities

BP 138/90 mm Hg

Heart rate 54 beats/min

Answer and Explanation

The Correct Answer is D

A) RR 18 bpm:
A respiratory rate of 18 breaths per minute is within the normal range for adults (12-20 bpm). Therefore, this finding does not pose a significant concern in the context of digoxin therapy. Respiratory rate should be monitored, especially if the patient is experiencing signs of heart failure or digoxin toxicity, but 18 bpm alone is not alarming.

B) 1+ pitting edema of the lower extremities:
Pitting edema, especially with a grade of 1+ (slight indentation), is a common finding in patients with congestive heart failure (CHF). It indicates fluid retention due to the heart's inability to pump blood effectively. While edema should be monitored, it is not immediately life-threatening or specific to digoxin toxicity.

C) BP 138/90 mm Hg:
A blood pressure of 138/90 mm Hg is slightly elevated, but it is not excessively high. This finding is manageable and should be monitored, particularly in heart failure patients, but it does not present an immediate concern in this case. Blood pressure management is crucial in CHF, but it does not directly correlate with digoxin toxicity.

D) Heart rate 54 beats/min:
A heart rate of 54 beats per minute is considered bradycardic, especially in a patient taking digoxin. Digoxin can lower heart rate by increasing vagal tone and inhibiting the AV node. Bradycardia is a well-known sign of digoxin toxicity, and this finding is concerning because it may indicate that the patient is experiencing toxicity. Digoxin-induced bradycardia can lead to more serious arrhythmias or hemodynamic instability, making this the most concerning finding that requires immediate assessment and possibly intervention.

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Correct Answer is B

Explanation

A) "My heart rate may increase":
Digoxin is primarily used to slow the heart rate, not increase it. One of its actions is to increase the force of contraction of the heart while slowing the conduction through the atrioventricular (AV) node, which typically leads to a decreased heart rate. An increase in heart rate would be an unusual side effect and might indicate digoxin toxicity or another underlying issue.

B) "My vision may get blurred":
A common side effect of digoxin toxicity is visual disturbances, which may include blurred vision, yellow-green halos, or other color vision abnormalities. These symptoms are often associated with elevated digoxin levels in the blood and are a hallmark sign of toxicity.

C) "I may have constipation after taking this medication":
Constipation is not a typical side effect of digoxin. While some medications may cause constipation, this is not a primary or common side effect of digoxin. If constipation occurs, it may be due to other factors, such as diet, other medications, or a comorbid condition.

D) "My abdomen may hurt after taking this medication":
Although abdominal discomfort can be a side effect of many medications, it is not a primary or typical side effect of digoxin. If the patient experiences abdominal pain, it could be related to digoxin toxicity, especially if accompanied by other symptoms like nausea, vomiting, or diarrhea.

A. 1 B. 0.06 C. 16.7 D. 0.12

Correct Answer is B

Explanation

The concentration provided is 0.5 g/3 mL.

Convert grams to milligrams:

0.5g=500mg

Now, the concentration is 500 mg/3 mL.

Find the concentration in mg/mL:

Concentration=(500mg/3mL)≈166.67mg/mL

Next, to find the volume needed for a 10 mg dose, use the formula:

Volume=(Desireddose(mg)/Concentration(mg/mL)

10mg/166.67mg/mL≈0.06mL/dose

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A patient is ordered to receive digoxin to treat congestive heart failure. The nurse is most concerned about which assessment finding.

Nursing Test Bank

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