The nurse is reinforcing teaching with a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include?

Check the pulse rate for 30 seconds and multiply the result by 2

Increase intake of sodium

Contact the health care provider for heart rate less than 60/min

Take the medication with food if you develop nausea

Answer and Explanation

The Correct Answer is C

A. Checking the pulse rate for 30 seconds and multiplying by 2 may not be accurate enough for a medication like digoxin, which requires precise monitoring.
B. Increasing sodium intake is not recommended for heart failure patients as it can worsen fluid retention and exacerbate symptoms.
C. Digoxin can cause bradycardia; therefore, it is crucial for clients to monitor their heart rate and contact their healthcare provider if it falls below 60/min to avoid adverse effects.
D. Taking digoxin with food can help with nausea but is not as critical as monitoring heart rate for potential toxicity.

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Correct Answer is A

Explanation

A. A PRN order is given as needed, based on the patient's condition or request.
B. A STAT order is for immediate administration.
C. A one-time order is for a single, specific instance.
D. A standing order is a pre-established and approved set of instructions for specific situations.

A. Leave the medication at the client's bedside. B. Come back in a few minutes to administer the medication in order to allow the client to finish with therapy. C. Prepare the medication in the medication room to quickly administer to the client once finished with therapy. D. Document the medication was given because the client will take it when they return to their room.

Correct Answer is B

Explanation

Leaving medication at the client's bedside is unsafe as it can lead to medication errors, missed doses, or accidental ingestion.
B. Coming back in a few minutes to administer the medication respects the client’s therapy schedule and ensures the nurse can directly observe the client taking the medication, ensuring proper administration and adherence.
C. Preparing the medication in the medication room ahead of time can be efficient but doesn’t address the need to personally administer the medication and confirm the client takes it.
D. Documenting the medication was given without actually administering it is unethical and against best practices as it assumes the client will take the medication without verification.

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The nurse is reinforcing teaching with a client who has a new prescription for digoxin to treat heart failure. Which of the following instructions should the nurse include?

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