The nurse is preparing a patient’s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48/min.
What should the nurse do next?
Withhold the dose and notify the health care provider.
Notify the health care provider and monitor the patient’s vital signs.
Recheck the pulse, making sure to count for 1 full minute.
Administer the dose.
The Correct Answer is A
Digoxin is a medication that can help the heart pump more blood and slow down the heart rate in certain conditions, such as heart failure and atrial fibrillation. However, digoxin has a narrow therapeutic range, which means that too much or too little of it can be harmful. The therapeutic range of digoxin levels in the blood is 0.5-2 ng/mL, and the toxic level is >2.4 ng/mL. Digoxin should be held if the resting apical pulse of an infant is <90 bpm, an older child is <70 bpm, or an adult is <60 bpm. A pulse of 48/min in an adult is too low and could indicate digoxin toxicity, which can cause life-threatening arrhythmias. Therefore, the nurse should withhold the dose and notify the health care provider immediately.
Choice B is wrong because notifying the health care provider and monitoring the patient’s vital signs are not enough.
The nurse should also withhold the dose to prevent further exposure to digoxin.
Choice C is wrong because rechecking the pulse, making sure to count for 1 full minute, is not necessary. The nurse should already have counted the pulse for 1 full minute before administering digoxin, as per standard procedure.
Choice D is wrong because administering the dose could worsen the patient’s condition and increase the risk of digoxin toxicity and arrhythmias.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Furosemide is a diuretic that lowers blood pressure and increases urine output. It also causes potassium loss, which can lead to hypokalemia (low potassium levels). The patient’s blood pressure is already low when sitting, and the serum potassium is below the normal range of 3.5 to 5.0 mEq/L. Administering furosemide could worsen these conditions and cause adverse effects such as dehydration, dizziness, muscle weakness, cardiac arrhythmias, and renal impairment. Therefore, the nurse should contact the provider before giving the medication and report the vital signs and laboratory results.
Choice A. Administer medication is wrong because it could harm the patient as explained above.
Choice C. Hold medication until next dose is wrong because it does not address the underlying problem of fluid retention and hypokalemia.
The nurse should not delay notifying the provider about the patient’s condition.
Choice D. Check urine output before giving medication is wrong because it is not enough to ensure the patient’s safety.
The nurse should also check the blood pressure and serum potassium levels, which are more critical indicators of the patient’s status.
Correct Answer is B
Explanation
Lifestyle is the greatest contributing factor that can lead to many diseases, especially noncommunicable diseases (NCDs) such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.According to the World Health Organization (WHO), NCDs are responsible for 74% of all deaths worldwide, and they share four major risk factors: tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets.These modifiable behaviours increase the risk of metabolic risk factors such as raised blood pressure, increased blood glucose, elevated blood lipids and obesity, which can lead to NCDs.
Choice A is wrong because trauma is not a factor that can lead to many diseases, but rather a result of injuries or accidents that damage the body.Trauma can cause acute or chronic conditions, such as infections, bleeding, fractures, organ failure or post-traumatic stress disorder, but it is not a common cause of NCDs.
Choice C is wrong because congenital means present at birth or inherited.
Congenital diseases are caused by genetic mutations or environmental factors that affect the development of the fetus.
Some examples of congenital diseases are Down syndrome, cystic fibrosis, congenital heart defects and spina bifida.
Congenital diseases are not the greatest contributing factor to many diseases because they are relatively rare and often detected early.
Choice D is wrong because genetics refers to the inherited traits from parents that influence the risk of developing certain diseases.
Genetics can play a role in some NCDs, such as cancers, diabetes and some cardiovascular diseases, but it is not the only or the most important factor.
Genetics interacts with environmental and lifestyle factors to determine the likelihood of developing a disease.
Therefore, genetics alone cannot lead to many diseases.
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