The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately?

Reference Range:
Sodium [Adult 136 to 145 mEq/L (136 to 145 mmol/L)]
Digoxin level (0.8 to 2.0 ng/mL (0.6 to 13 nmol/L)]
Potassium (K+) [Adult: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]

Digoxin level of 1.1 ng/mL (1.4 nmol/L).

Creatinine level of 0.8 mg/dL (70.72 μmol/L).

Potassium level of 3.2 mEq/L (3.2 mmol/L).

Sodium level of 135 mEq/L (135 mmol/L).

Answer and Explanation

The Correct Answer is C

A. Digoxin level of 1.1 ng/mL (1.4 nmol/L):
A digoxin level of 1.1 ng/mL is within the therapeutic range (0.8 to 2.0 ng/mL). While it is important to monitor digoxin levels, this value does not indicate an immediate concern.

B. Creatinine level of 0.8 mg/dL (70.72 μmol/L):
A creatinine level of 0.8 mg/dL is within the normal range (0.5 to 1.1 mg/dL) and does not indicate any renal impairment or immediate issue.

C. Potassium level of 3.2 mEq/L (3.2 mmol/L):
A potassium level of 3.2 mEq/L is below the normal range (3.5 to 5.0 mEq/L). Hypokalemia can increase the risk of digoxin toxicity and arrhythmias, making this an urgent issue that should be reported to the healthcare provider immediately.

D. Sodium level of 135 mEq/L (135 mmol/L):
A sodium level of 135 mEq/L is slightly below the normal range (136 to 145 mEq/L), but it is not as critical as a significantly abnormal potassium level in the context of digoxin use. While it should be monitored, it is less urgent compared to the potassium level.

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Correct Answer is A

Explanation

A. When signs of severe hypoglycemia occur:
Glucagon is used to rapidly increase blood glucose levels in cases of severe hypoglycemia when the person is unable to eat or drink. It is administered in emergency situations where the individual is unconscious or unable to consume oral glucose.

B. Before meals to prevent hyperglycemia:
Glucagon is not used to prevent hyperglycemia or as a routine preventive measure. It is specifically for emergency treatment of severe hypoglycemia.

C. When unable to eat during sick days:
While glucagon can be used if the person is unable to eat due to severe hypoglycemia, it is not typically used as a preventative measure for situations where the client is simply unable to eat. Regular monitoring and management of blood glucose levels are necessary during illness.

D. At the onset of signs of diabetic ketoacidosis:
Glucagon is not used to treat diabetic ketoacidosis (DKA). DKA is managed with insulin, fluids, and electrolytes, not glucagon.

A. Use the cream only on intact skin. B. Apply the cream to the area for 2 weeks. C. Cover the site with an occlusive dressing. D. Limit exposure to direct sunlight.

Correct Answer is C

Explanation

A) Use the cream only on intact skin: This is correct advice as applying betamethasone cream to broken or infected skin can exacerbate the condition or lead to systemic absorption and side effects. Ensuring the cream is applied only to intact skin helps prevent complications.

B) Apply the cream to the area for 2 weeks: This instruction is appropriate depending on the severity of the eczema and the prescribing healthcare provider’s guidance. Typically, topical corticosteroids like betamethasone are used for a prescribed duration, often not exceeding 2 weeks to avoid potential side effects.

C) Cover the site with an occlusive dressing: This indicates a need for further teaching. Occlusive dressings are generally not recommended with topical corticosteroids unless specifically instructed by a healthcare provider. They can increase the absorption of the medication, potentially leading to more side effects, such as thinning of the skin.

D) Limit exposure to direct sunlight: This is good advice because corticosteroids can increase skin sensitivity to sunlight, leading to potential sunburn or other skin issues. Clients should be advised to protect their skin from excessive sun exposure while using such medications.

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Naxlex Comprehensive Predictor Exams

A glucagon emergency kit is prescribed for a client with type 1 diabetes mellitus. When should the nurse instruct the client and family that glucagon needs to be administered?

Correct Answer is A

Explanation

A client with eczema receives a prescription for betamethasone cream. Which client statement indicates to the nurse that further teaching is needed?

Correct Answer is C

Explanation

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