The nurse reviews the entries in the medical record.

Admission Assessment 0900:
Client reports, "I'm bloated and my stomach hurts." History of prior illness: Client reports a 3-week history of gnawing abdominal pain. Client states, "It's a burning sensation that radiates to my back. I think I've lost a little weight too." Reports one episode of dark, tarry stool. No vomiting. Client reports pain is worse about 1 hr after eating a meal. Past medical history: Osteoarthritis
Social history: Recently divorced, drinks in moderation (3 to 4 drinks per week), smokes tobacco
Current medications:

Ibuprofen 800 mg three times daily PRN arthritis pain Physical Examination:

General: client appears uncomfortable, diaphoretic

Head, ears, eyes, nose, and throat (HEENT): oropharynx clear, mucous membranes moist and pale
Respiratory: bilateral breath sounds clear

Gastrointestinal: epigastric tenderness to palpation, no rebound tenderness or guarding Neurological: oriented x 3 (person, place, and time)

The nurse is ready to begin. For each potential nursing action, specify if the action is indicated or not indicated for the client.
Nursing Actions

A. Correct. Offering information about respite care provides the son with an option to take a break and get some rest while ensuring his mother's care is still managed by professionals.

B. Incorrect. While supportive, this statement does not offer a solution to the son's sleep deprivation.

C. Incorrect. Suggesting a sleeping pill might not address the underlying issue of the son's caregiving responsibilities.

D. Incorrect. While empathetic, this statement does not offer a practical solution or support for the son's situation.

Digoxin is a medicine used to treat various heart conditions, including heart failure and irregular heartbeat1. It is important to follow the doctor’s instructions carefully when giving digoxin to your child, as the dosage and timing may vary depending on your child’s age, weight, and medical condition.

Out of the four statements you provided, only one is correct. The correct statement is:

d. “Have your child drink a small glass of water after swallowing the medication.”

This statement is correct because drinking water after taking digoxin can help prevent stomach upset and ensure proper absorption of the medicine.

The other three statements are incorrect and should not be followed. Here are the reasons why:

a. “You can add the medication to a half-cup of your child’s favorite juice.”

This statement is incorrect because adding digoxin to juice or other liquids can alter the concentration and effectiveness of the medicine4. You should give digoxin to your child by mouth with or without food, using a marked measuring spoon or medicine cup. If you are using the liquid form of digoxin, you can give a small squirt of the medicine inside the cheek and let your child swallow it before giving more.

b. “Repeat the dose if your child vomits within 1 hour after taking the medication.”

This statement is incorrect because repeating the dose of digoxin can increase the risk of overdose and side effects4. Digoxin has a narrow therapeutic range, which means that too much or too little of the medicine can be harmful. If your child vomits within 1 hour after taking digoxin, do not give another dose and continue with the normal dose amount at the next scheduled time4. If your child vomits frequently or has signs of overdose, such as nausea, drowsiness, confusion, vision changes, or irregular heartbeat, call your doctor or poison control center immediately.

c. “Limit your child’s potassium intake while she is taking this medication.”

This statement is incorrect because limiting your child’s potassium intake can actually worsen the effects of digoxin6. Digoxin works by affecting the levels of sodium and potassium in the heart cells, which helps regulate the heart rhythm and contractility. However, low potassium levels can make digoxin more toxic and increase the risk of arrhythmias6. Therefore, you should not restrict your child’s potassium intake unless instructed by your doctor6. You should also avoid giving your child foods or supplements that are high in fiber, as they can interfere with the absorption of digoxin. Some examples of high-fiber foods are bran, psyllium, and some fruits and vegetables