A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following manifestations should the nurse report to the provider as an indication of digoxin toxicity?
Vomiting.
Dilated pupils.
Bruising.
Peripheral edema.
The Correct Answer is A
Choice A rationale
Vomiting is a common sign of digoxin toxicity. Other symptoms include nausea, confusion, and visual disturbances.
Choice B rationale
Dilated pupils are not a typical sign of digoxin toxicity. Symptoms are more related to gastrointestinal and cardiac effects.
Choice C rationale
Bruising is not directly associated with digoxin toxicity. It may indicate other issues such as coagulopathy.
Choice D rationale
Peripheral edema is not a specific sign of digoxin toxicity. It is more commonly associated with heart failure.
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Correct Answer is C
Explanation
Choice A rationale
Incorrect packaging, such as a topical medication packaged as an oral medication, can lead to medication errors. However, it is not the most frequent cause of fatal medication errors. Packaging errors are relatively rare and usually caught before administration.
Choice B rationale
Delivery device problems, such as an infusion pump malfunction, can cause medication errors. These errors can be serious but are not the most frequent cause of fatal medication errors. Device malfunctions are often detected and corrected by healthcare professionals.
Choice C rationale
Name confusion between two medications with similar sounding names is the most frequent cause of fatal medication errors. This type of error occurs when medications with similar names are confused, leading to the administration of the wrong drug. This can have serious and sometimes fatal consequences.
Choice D rationale
Incorrect labeling of a medication dispensed by the pharmacy can lead to medication errors. While labeling errors are a significant concern, they are not the most frequent cause of fatal medication errors. These errors are often identified and corrected before administration.
Correct Answer is C
Explanation
Choice A rationale
Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.
Choice B rationale
Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.
Choice C rationale
Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.
Choice D rationale
Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.