Urine dipstick:
pH 6.0 mg/dl. (4.6 to 8 mg/dL)

Specific Gravity 1.022 (1.010 to 1.025)

Leukocyte esterase negative (Negative)

Nitrite negative (Negative)

Protein trace negative (Negative)

Glucose negative (Negative)

Ketones none (None)

Bilirubin none (None)

Blood none (None)

Which of the following statements should the nurse include in the client's teaching?

Select all that apply.

A.    Wheezes - Latex Allergy. Wheezing is often associated with allergic reactions, including latex allergy. Latex allergy can cause airway constriction and result in wheezing.

B.    Tachycardia - All Thr ee Conditions (Malignant Hyperthermia, Latex Allergy, Hypovolemic Shock). Tachycardia can be a common response to stress or physiological changes. In malignant hyperthermia, tachycardia can occur due to the hypermetabolic state. Latex allergy can cause an anaphylactic reaction leading to tachycardia. In hypovolemic shock, the heart rate increases to compensate for decreased blood volume.

C.    Urticaria - Latex Allergy. Urticaria (hives) is a classic sign of an allergic reaction, including latex allergy.
 
D.    Hypercapnia - Malignant Hyperthermia. Hypercapnia (elevated levels of carbon dioxide in the blood) can be a sign of malignant hyperthermia due to increased muscle metabolism and metabolic acidosis.

E.    Muscle Rigidity - Malignant Hyperthermia. Muscle rigidity is a hallmark sign of malignant hyperthermia, a rare but potentially life-threatening reaction to certain medications used during anesthesia.

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