A nurse is preparing to administer digoxin to a pediatric client who has heart failure. Which of the following actions is appropriate?
Instructing the client to eat foods that are low in potassium.
Repeat the dose if the client spits it out.
Measuring apical pulse rate for 30 seconds before administration.
Evaluating the client for nausea, vomiting, and anorexia.
The Correct Answer is C
A. Clients on digoxin should actually have an adequate intake of potassium, as low potassium levels can increase the risk of digoxin toxicity.
B. If a pediatric client spits out digoxin, the dose should not be repeated automatically; instead, the nurse should assess the situation and follow the facility's protocol regarding missed doses.
C. Measuring the apical pulse for one full minute before administering digoxin is critical; if the pulse is below the established threshold (usually <60 bpm for children), the medication should be held and the provider notified.
D. While evaluating for nausea, vomiting, and anorexia is important, it is not an appropriate immediate action before administering the medication. The priority action is to assess the apical pulse.
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Correct Answer is A
Explanation
A. Holding breath for 10 seconds after inhaling the medication allows for better absorption of the medication in the lungs, indicating understanding of proper inhaler technique.
B. Taking a quick inhalation is incorrect; the client should take a slow, deep breath to ensure the medication reaches the lungs effectively.
C. Waiting 10 minutes between inhalations is not necessary unless specifically instructed; usually, a second puff can be taken after 1-2 minutes if needed.
D. The client should exhale before inhaling the medication, not while it is being released; exhaling first clears the lungs for a more effective inhalation.
Correct Answer is ["A","C","D","E"]
Explanation
A. The parent applying prescribed medication as instructed indicates proper understanding of post-operative care and adherence to treatment.
B. Allowing the child to lift their older sibling above the ground is inappropriate as it can lead to increased pressure on the ear, risking complications.
C. Enforcing nose blowing only when necessary is a correct action since excessive force can displace the tympanoplasty tube or introduce bacteria into the ear.
D. Planning to have the child use ear plugs in the shower is an effective precaution to protect the ears from water exposure, which is essential post-surgery.
E. Reporting purulent drainage immediately to the surgeon shows awareness of potential complications and the need for prompt medical attention.