Which is the most appropriate nursing action related to the administration of digoxin (Lanoxin) to an infant?
Checking respiratory rate and blood pressure before each dose
Counting the apical rate for 30 seconds before administering the medication
Withholding a dose if the apical heart rate is less than 100 beats/minute
Repeating a dose if the child vomits within 30 minutes of the previous dose
The Correct Answer is C
A. Checking respiratory rate and blood pressure before each dose: While respiratory status and BP are important, apical heart rate is the most critical parameter to assess due to the drug's potential for causing bradycardia.
B. Counting the apical rate for 30 seconds before administering the medication: The apical heart rate should be counted for a full 1 minute in infants, not 30 seconds.
C. Withholding a dose if the apical heart rate is less than 100 beats/minute: Digoxin should be held if the apical HR is <100 bpm in infants, due to risk of bradycardia and cardiac arrest.
D. Repeating a dose if the child vomits within 30 minutes of the previous dose: A repeat dose is not recommended without physician consultation, as vomiting may be a sign of toxicity.
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Related Questions
Correct Answer is D
Explanation
A. Machine-like murmur: This is a hallmark finding of patent ductus arteriosus (PDA), not coarctation.
B. Severe cyanosis: Cyanosis is more typical in conditions with right-to-left shunting, not coarctation.
C. Pulmonary edema: May occur in heart failure but is not a primary or specific sign of coarctation.
D. Decreased blood pressure in the legs: Coarctation of the aorta causes narrowing, leading to higher BP in the upper extremities and lower BP in the legs.
Correct Answer is D
Explanation
A. Oxygen therapy: Oxygen therapy may be used during acute complications but is not the mainstay of treatment.
B. A diet high in iron: Iron overload is already a complication of repeated transfusions; high iron intake is contraindicated.
C. Bed rest until the sedimentation rate is normal: Bed rest is not a specific treatment for thalassemia and ESR is not a key indicator for this condition.
D. Multiple blood transfusions: Frequent transfusions are the primary treatment for thalassemia major to maintain normal hemoglobin levels and suppress ineffective erythropoiesis.
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