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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Free Nursing Study Resources

Correct Answer is B

Explanation

A. Notify the healthcare provider of lethargy:
Cimetidine can cause side effects such as confusion and lethargy, especially in the elderly or those with renal impairment. Reporting these symptoms to the healthcare provider is important for proper management and potential adjustment of treatment.

B. Decrease cigarette use to a pack per day:
This statement indicates a misunderstanding of the impact of smoking on peptic ulcer disease. Smoking can exacerbate ulcer symptoms and interfere with healing. The nurse should instruct the client to ideally quit smoking altogether rather than just reducing the amount.

C. Monitor for any signs of sexual dysfunction:
Cimetidine can cause sexual dysfunction, including decreased libido and erectile dysfunction. The client should be aware of this potential side effect and report any such issues to their healthcare provider for further evaluation and management.

D. Take the medication an hour after antacids:
Cimetidine should not be taken simultaneously with antacids as this can interfere with its absorption. Taking cimetidine an hour after antacids is a correct approach to avoid interaction and ensure effective medication action.

A. Use relaxation techniques to reduce excessive anxiety. B. Stop taking the medication if intended effect is not immediate. C. Avoid alcohol and other sedatives while taking the medication. D. Move slowly from a sitting position to a standing position.

Correct Answer is B

Explanation

A. Use relaxation techniques to reduce excessive anxiety:
This is a good practice and complements the use of medication for managing anxiety. Relaxation techniques can help improve overall anxiety control.

B. Stop taking the medication if intended effect is not immediate:
Lorazepam, a benzodiazepine, typically starts working within hours to a few days, but it is not instantaneously effective for all individuals. Stopping the medication prematurely without consulting the healthcare provider can be harmful and is not advised. It is important to follow the prescribed regimen and consult the provider for any concerns.

C. Avoid alcohol and other sedatives while taking the medication:
This is crucial advice as combining lorazepam with alcohol or other sedatives can increase the risk of severe sedation, respiratory depression, and impaired motor skills.

D. Move slowly from a sitting position to a standing position:
This is a recommended practice to avoid dizziness or orthostatic hypotension, which can be a side effect of lorazepam and other benzodiazepines.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with peptic ulcer disease receives a new prescription for cimetidine. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is B

Explanation

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