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) Pulse oximetry of 92%: While a pulse oximetry reading of 92% is slightly below normal, it is not a definitive reason to hold verapamil. This reading indicates mild hypoxemia, but it does not directly contraindicate the use of verapamil. Other factors should be considered before making a decision based solely on this value.
B) Pulse of 78: A pulse rate of 78 beats per minute is within the normal range for adults and does not warrant holding verapamil. This finding alone does not indicate any immediate concerns related to the administration of the medication.
C) Respiratory rate of 12: A respiratory rate of 12 breaths per minute is within the normal range for adults. This finding does not provide any indication that verapamil should be withheld. It is important to consider other clinical factors when assessing the appropriateness of medication administration.
D) History of myocardial infarction a week ago: Verapamil, a calcium channel blocker, can have significant effects on cardiac function. Administering it to a client who recently experienced a myocardial infarction (heart attack) could exacerbate cardiac issues and lead to complications. Therefore, it is crucial to hold the medication and consult with the healthcare provider before proceeding.
Correct Answer is C
Explanation
A) Platelet counts: Monitoring platelet counts is not necessary with atorvastatin therapy. While certain medications may affect platelet levels, atorvastatin primarily targets lipid levels and does not have a significant impact on platelet function.
B) Lung function test: Lung function tests are not relevant for atorvastatin use. These tests are typically utilized for assessing respiratory conditions and are not part of the routine monitoring for cholesterol-lowering medications.
C) Liver function test: Atorvastatin can affect liver function, so it is essential to monitor liver
enzymes (such as AST and ALT) regularly. Routine liver function tests help identify any potential hepatotoxicity early, allowing for timely intervention if liver function declines.
D) Bun and creatinine levels: While monitoring renal function can be important in some contexts, it is not a routine requirement specifically for atorvastatin. However, it may be necessary in certain patient populations or if there are concerns about kidney function, but liver function tests are the primary focus with this medication.