The home health nurse is conducting an initial home visit for an infant who was recently discharged from the hospital with heart failure. During this visit, the nurse is discussing the proper administration of digoxin with the parents. Which intervention(s) should the nurse include when providing guidance to the parents? Select all that apply.

Instruct to give additional dose if the baby vomits after administration.

Demonstrate how to measure the correct amount of the oral solution.

Notify the healthcare provider before giving digoxin if your baby is ill.

Show the correct technique to obtain an apical pulse.

Administer digoxin on a strict every 12-hour schedule.

Answer and Explanation

Correct Answer : B,C,D,E

A. Instruct to give additional dose if the baby vomits after administration: Giving an extra dose after vomiting can result in digoxin toxicity because the exact amount absorbed is uncertain. Parents should never repeat a dose without consulting the healthcare provider.

B. Demonstrate how to measure the correct amount of the oral solution: Accurate measurement is critical for safe digoxin administration, as small errors can lead to underdosing or toxicity. Using an appropriate oral syringe or dropper ensures the correct dose.

C. Notify the healthcare provider before giving digoxin if your baby is ill: Illness can affect heart rate, hydration, and electrolyte balance, which increases the risk of digoxin toxicity. Parents should contact the provider to determine whether to hold or adjust the dose.

D. Show the correct technique to obtain an apical pulse: Digoxin can slow the heart rate. Parents should learn to assess the apical pulse for a full minute and understand the parameters for withholding medication based on heart rate guidelines.

E. Administer digoxin on a strict every 12-hour schedule: Maintaining consistent timing ensures stable blood levels, improving efficacy and reducing the risk of toxicity. A strict schedule is essential for therapeutic effectiveness.

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Correct Answer is ["B","C"]

Explanation

A. Tremors: Benztropine is an anticholinergic used to reduce tremors in Parkinson’s disease, so tremors are not an expected adverse effect of this medication.

B. Urinary retention: Anticholinergic effects of benztropine can decrease bladder contractility, leading to urinary retention, which is a common side effect that clients should monitor.

C. Blurred vision: Benztropine can cause blurred vision due to its anticholinergic effect on the eyes, including pupillary dilation and impaired accommodation. Clients should be cautioned about visual changes.

D. Diarrhea is uncommon with benztropine; in fact, anticholinergic medications more often cause constipation rather than diarrhea.

E. Drooling: Benztropine reduces salivation, so drooling is not expected. The medication may actually help decrease excessive salivation associated with Parkinson’s disease.

A. Place a warm blanket on the client. B. Administer IV fluids per protocol. C. Review the medication administration record. D. Check the urinary catheter r an occlusion.

Correct Answer is B

Explanation

A. Place a warm blanket on the client: Providing warmth may improve comfort temporarily but does not address the underlying cause of the client’s cool, moist hands, prolonged capillary refill, or low urine output, which suggest possible hypovolemia or shock.

B. Administer IV fluids per protocol: The client’s signs restlessness, cool clammy skin, prolonged capillary refill, and low urine output indicate hypoperfusion likely due to fluid deficit. Administering IV fluids promptly helps restore circulating volume and tissue perfusion.

C. Review the medication administration record: While medication review is important for overall safety, it does not address the immediate risk of hypovolemic shock or low urine output in this client.

D. Check the urinary catheter for an occlusion: Although checking for blockage is reasonable if a catheter is present, the client’s overall clinical presentation points to systemic hypovolemia rather than a localized urinary obstruction.

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Naxlex Comprehensive Predictor Exams

A client with Parkinson's disease receives a prescription for benztropine. Which common adverse effect(s) should the nurse include in the teaching plan? Select all that apply

Correct Answer is ["B","C"]

Explanation

The nurse is caring for a postoperative client who has a saline lock and minimal urine in the drainage bag, who appears anxious and restless. The nurse notices that the client's hands are cool and moist, with prolonged capillary refill. Which action should the nurse take?

Correct Answer is B

Explanation

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Which assessment should the home health nurse include during a routine home visit for a client who was discharged home with a suprapubic catheter?