The nurse is preparing a patient\u2019s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48\/min.
What should the nurse do next?<\/p>\n\n\n\n
A.
Withhold the dose and notify the health care provider.<\/p>\n\n\n\n
B.
Notify the health care provider and monitor the patient\u2019s vital signs.<\/p>\n\n\n\n
C.
Recheck the pulse, making sure to count for 1 full minute.<\/p>\n\n\n\n
D.
Administer the dose.<\/p>\n\n\n\n
The Correct Answer and Explanation is :<\/mark><\/strong><\/p>\n\n\n\n The correct answer is: A. Withhold the dose and notify the health care provider.<\/strong><\/p>\n\n\n\n Explanation:<\/strong><\/p>\n\n\n\n Digoxin (Lanoxin) is a cardiac glycoside that increases the force of myocardial contractions and is commonly used to treat heart failure, atrial fibrillation, and other heart conditions. It improves cardiac output by increasing the force of each heartbeat while slowing the heart rate, which enhances the efficiency of the heart. However, digoxin has a narrow therapeutic index, meaning there is a small margin between a therapeutic dose and a toxic dose. Therefore, careful monitoring of the patient\u2019s heart rate is crucial before administering the medication.<\/p>\n\n\n\n Apical Pulse and Digoxin<\/strong> In this scenario, the patient’s apical pulse is 48 bpm, which is below the acceptable range for safely administering digoxin. If digoxin is given under these conditions, it may exacerbate the bradycardia, leading to further cardiac complications, including heart block or other life-threatening arrhythmias.<\/p>\n\n\n\n Next Steps<\/strong> By withholding the medication and notifying the health care provider, the nurse is acting to prevent adverse effects and safeguard the patient’s health.<\/p>\n","protected":false},"excerpt":{"rendered":" The nurse is preparing a patient\u2019s daily dose of digoxin (Lanoxin), an inotropic drug. The adult patient has an apical pulse of 48\/min.What should the nurse do next? A.Withhold the dose and notify the health care provider. B.Notify the health care provider and monitor the patient\u2019s vital signs. C.Recheck the pulse, making sure to count […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-136597","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/136597","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=136597"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/136597\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=136597"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=136597"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=136597"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}
One of the critical assessments before administering digoxin is checking the patient’s apical pulse for a full minute. According to clinical guidelines, the drug should be withheld if the apical pulse falls below 60 beats per minute (bpm) in adults. A pulse rate below this threshold increases the risk of bradycardia, a condition where the heart rate becomes dangerously slow. Bradycardia can lead to inadequate cardiac output and potentially serious complications, such as dizziness, hypotension, and even syncope (fainting).<\/p>\n\n\n\n
The nurse should withhold the dose of digoxin and immediately notify the health care provider. This action allows the provider to reassess the patient\u2019s condition, adjust the digoxin dosage if needed, or explore other treatments. Monitoring the patient’s vital signs closely after holding the medication is also important to ensure no further complications arise.<\/p>\n\n\n\n