A patient taking Digoxin is experiencing severe bradycardia, nausea and vomiting. A lab draw shows that their Digoxin level is 4 ng/mi (0.8-2.0 ng/ml). What management does the nurse anticipate the physician to order? Select all that apply.

Hydration with IV fluids

Nothing as the digoxin level is within normal ranges

Hold the Digoxin

Digibind

Narcan

Answer and Explanation

Correct Answer : A

A) Hydration with IV fluids:
IV hydration may be ordered to improve kidney function and help facilitate the excretion of excess digoxin from the body. Digoxin toxicity is often related to impaired renal clearance, so improving hydration can promote renal perfusion and enhance the elimination of the drug. This is a common supportive measure to help in managing digoxin toxicity.

B) Nothing as the digoxin level is within normal ranges:
This is incorrect because the patient's digoxin level is 4 ng/ml, which is significantly above the normal therapeutic range of 0.8–2.0 ng/ml. A level of 4 ng/ml is toxic, and immediate action is required. Symptoms like severe bradycardia, nausea, and vomiting are indicative of digoxin toxicity, and they necessitate prompt intervention.

C) Hold the Digoxin:
In the case of digoxin toxicity, it is crucial to hold the digoxin. Digoxin should be discontinued immediately if toxicity is suspected, as continuing the medication could worsen symptoms like bradycardia and increase the risk of potentially life-threatening arrhythmias. This step is essential to prevent further complications.

D) Digibind:
Digibind (Digoxin immune fab) is a digoxin-specific antibody used in cases of severe digoxin toxicity or overdose. It binds to the digoxin molecules and helps to neutralize its effects. Given the elevated level of digoxin (4 ng/ml) and the presence of symptoms like severe bradycardia, nausea, and vomiting, Digibind is likely to be ordered to reverse the effects of the toxicity.

E) Narcan:
Narcan (naloxone) is used to reverse opioid overdoses, not digoxin toxicity. There is no indication for the use of Narcan in this scenario, as digoxin toxicity does not involve opioid overdose. This intervention would be inappropriate and irrelevant to the management of digoxin toxicity.

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Correct Answer is C

Explanation

A) Bradycardia:
Benztropine is an anticholinergic medication used to manage the symptoms of Parkinson's disease by blocking the action of acetylcholine. While anticholinergic medications can affect heart rate, bradycardia is not a common side effect of benztropine. In fact, benztropine may have the opposite effect, potentially causing tachycardia (increased heart rate).

B) Excess salivation:
Excessive salivation is typically a symptom of Parkinson's disease itself, due to difficulty swallowing, rather than a side effect of benztropine. In fact, benztropine, as an anticholinergic agent, generally reduces salivation (anticholinergic effect), so this side effect is unlikely to occur with benztropine therapy.

C) Urinary retention:
Benztropine, being an anticholinergic drug, can inhibit the action of acetylcholine at muscarinic receptors in the bladder, leading to urinary retention. This is a common and serious side effect of anticholinergic drugs like benztropine. Urinary retention can lead to discomfort, urinary tract infections (UTIs), and kidney problems if not addressed.

D) Diarrhea:
Benztropine is more likely to cause constipation rather than diarrhea due to its anticholinergic effects. Anticholinergic medications often slow down gastrointestinal motility, leading to constipation.

A. 250 mg B. 25 mg C. 5 mg D. 200 mg

Correct Answer is B

Explanation

A. 250 mg:

This represents the amount of levodopa in the tablet, not carbidopa. Sinemet contains two active ingredients: carbidopa (25 mg) and levodopa (250 mg), as shown on the label.

B. 25 mg:

This is the correct answer, as the label indicates that each tablet contains 25 mg of carbidopa. Carbidopa is combined with levodopa to improve its effectiveness and reduce side effects like nausea.

C. 5 mg:

This is not accurate; the label clearly states that the carbidopa dose is 25 mg per tablet.

D. 200 mg:

This does not correspond to the dose of carbidopa or levodopa in this medication. The label specifies 25 mg of carbidopa and 250 mg of levodopa.

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A patient taking Digoxin is experiencing severe bradycardia, nausea and vomiting. A lab draw shows that their Digoxin level is 4 ng/mi (0.8-2.0 ng/ml). What management does the nurse anticipate the physician to order? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who taking benztropine to treat Parkinson's disease. The nurse should instruct the client to monitor and report which of the following side effects of benztropine?

Correct Answer is C

Explanation

How many milligrams of carbidopa is this patient taking per dose/tablet?

Correct Answer is B

Explanation

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