he nurse is preparing to administer digoxin (Lanoxin) to a client experiencing atrial fibrillation. Which of the following electrolyte imbalances would the nurse assess to reduce the incidence of toxicity with digoxin (Lanoxin)?
hypokalemia
hyperkalemia
hypocalcemia
hypernatremia
The Correct Answer is A
A) Hypokalemia: Hypokalemia, or low potassium levels, significantly increases the risk of digoxin toxicity. Since digoxin competes with potassium for binding at the sodium-potassium ATPase site in the heart, low potassium levels can lead to increased digoxin effects and toxicity. Therefore, it is crucial to monitor potassium levels and correct any deficiencies before administering digoxin.
B) Hyperkalemia: While hyperkalemia is a serious concern and can also affect digoxin therapy, it usually results in decreased effectiveness of digoxin rather than increasing toxicity. Elevated potassium levels can diminish the drug's positive inotropic effect.
C) Hypocalcemia: Although calcium levels can influence cardiac function, hypocalcemia is not directly related to digoxin toxicity. Monitoring calcium is important for overall cardiac health, but it is not the primary focus when assessing the risk for digoxin toxicity.
D) Hypernatremia: Elevated sodium levels do not have a direct impact on the efficacy or toxicity of digoxin. While sodium levels are essential to monitor for overall health, they are not critical in the context of digoxin administration and toxicity risk.
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Correct Answer is D
Explanation
A) "Increase your potassium intake by eating more bananas and apricots.": Doxazosin is not a potassium-sparing medication, and there is no specific indication for increased potassium intake with this drug. This advice may be misleading, especially since excessive
potassium can pose risks, particularly in certain populations.
B) "Weigh yourself daily, and report any weight loss to your prescriber.": Daily weighing can be important for monitoring fluid retention in some conditions, but weight loss is not a common side effect of doxazosin. Instead, clients should be more concerned about weight gain due to fluid retention or potential side effects from the medication.
C) "The impaired taste associated with this medication usually goes away in 2 to 3 weeks.": Impaired taste is not a well-documented side effect of doxazosin. While some medications may cause changes in taste, this statement is not relevant for doxazosin and does not address the most critical aspects of its administration.
D) "Be sure to lie down after taking the first dose, because first-dose hypotension may make you dizzy.": This statement is accurate and important. Doxazosin can cause first-dose hypotension, leading to dizziness or fainting. Advising the client to lie down after the first dose helps mitigate the risk of hypotensive effects, making this the most appropriate emphasis for the nurse.
Correct Answer is D
Explanation
A) Pancytopenia: While some medications can cause pancytopenia, it is not a common or direct side effect of alteplase. This condition involves a reduction in red blood cells, white blood cells, and platelets, and is not typically associated with thrombolytics.
B) Hypertension: Alteplase is not known to cause hypertension. In fact, the goal of administering alteplase in the context of a pulmonary embolism is to dissolve the clot and restore normal blood flow, which may help stabilize blood pressure.
C) Hypokalemia: This condition, characterized by low potassium levels, is not a common side effect of alteplase. There are other medications that may cause electrolyte imbalances, but alteplase itself is not typically linked to hypokalemia.
D) Internal bleeding: This is a significant risk associated with alteplase, as it is a thrombolytic agent that dissolves clots. The nurse should closely monitor for signs of internal bleeding, such as changes in vital signs, unexplained bruising, or blood in urine or stool. This is the most critical side effect to assess for in a client receiving alteplase