DIGOXIN TOXICTY AND LOOP DIURETICS NUR187
EXAM QUESTIONS AND ANSWERS VERIFIED
When educating Ms. Richards about digoxin, the nurse determines teaching has
been effective if the patient states which of the following? (Select all that apply.)
"I will take my prescribed dose at the same time every day and keep a written record of
the date and time of administration.", "If I forget to take my daily dose, I can still take it if
within 6 hours of when I should have taken it.", "I should have periodic blood work."
When Mary Richards receives a potassium infusion, the nurse should prioritize
which of the following assessments? (Select all that apply.)
Your Response: Assess apical pulse for 1 full minute before each administration,
Monitor serum digoxin level, Administer with food to prevent stomach upset, Monitor for
visual color changes, Assess the patient for the presence of a pulse deficit
Digoxin toxicity may be noted with a digoxin level above 2 ng/mL. Therapeutic
range for digoxin levels would be between 0.8 and 2.0 ng/mL.
Signs of toxicity include potentially life-threatening heart rhythm disturbances, ranging
from slow to rapid ventricular rhythm. Premature ventricular contractions (PVCs) occur
commonly with digoxin toxicity and are usually perceived as "skipped" heartbeats by
patients. However, PVCs have many possible causes and therefore are not specific for
digoxin toxicity. Other adverse effects include dizziness, nausea, vomiting, loss of
appetite, abdominal discomfort, vision changes (yellow-green halos and problems with
color perception), blurred vision, and mental changes.
, After an assessment of Mary Richards, the nurse determines that which of the
following are manifestations of digoxin toxicity? (Select all that apply.)
Visual disturbances, Nausea, Abdominal pain, Confusion
Rationale:Vision problems, nausea, dizziness, weakness, confusion, and abdominal
pain are indicators of digoxin toxicity.
The nurse recognizes which of the following factors for Mary Richards as
contributing to the risk for digoxin toxicity? (Select all that apply.)
Age, Prescription for diuretic, Vomiting and diarrhea
Rationale:Patients over the age of 80 may be at higher risk of digoxin toxicity due to
normal renal changes that occur with advanced age. Digoxin toxicity can be caused by
electrolyte disturbances, such as potassium depletion, caused by concurrent use of
diuretics. GI fluid loss via vomiting and/or diarrhea may lead to potassium losses, which
will increase digoxin levels. The other answer choices do not place Mary Richards at an
increased risk for digoxin toxicity.
The nurse is preparing to administer digoxin 0.25 mg and furosemide 40 mg to a
patient. The patient reports seeing yellow halos around the lights in the room.
Which of the following is the priority action for the nurse to take?
Withhold the digoxin
Rationale:Presence of yellow halos is a symptom of digoxin toxicity. The nurse should
withhold digoxin. Potassium would only be administered if laboratory values indicate.
Verifying furosemide dose and assessing blood pressure are not priority actions based
on the patient's symptoms.
EXAM QUESTIONS AND ANSWERS VERIFIED
When educating Ms. Richards about digoxin, the nurse determines teaching has
been effective if the patient states which of the following? (Select all that apply.)
"I will take my prescribed dose at the same time every day and keep a written record of
the date and time of administration.", "If I forget to take my daily dose, I can still take it if
within 6 hours of when I should have taken it.", "I should have periodic blood work."
When Mary Richards receives a potassium infusion, the nurse should prioritize
which of the following assessments? (Select all that apply.)
Your Response: Assess apical pulse for 1 full minute before each administration,
Monitor serum digoxin level, Administer with food to prevent stomach upset, Monitor for
visual color changes, Assess the patient for the presence of a pulse deficit
Digoxin toxicity may be noted with a digoxin level above 2 ng/mL. Therapeutic
range for digoxin levels would be between 0.8 and 2.0 ng/mL.
Signs of toxicity include potentially life-threatening heart rhythm disturbances, ranging
from slow to rapid ventricular rhythm. Premature ventricular contractions (PVCs) occur
commonly with digoxin toxicity and are usually perceived as "skipped" heartbeats by
patients. However, PVCs have many possible causes and therefore are not specific for
digoxin toxicity. Other adverse effects include dizziness, nausea, vomiting, loss of
appetite, abdominal discomfort, vision changes (yellow-green halos and problems with
color perception), blurred vision, and mental changes.
, After an assessment of Mary Richards, the nurse determines that which of the
following are manifestations of digoxin toxicity? (Select all that apply.)
Visual disturbances, Nausea, Abdominal pain, Confusion
Rationale:Vision problems, nausea, dizziness, weakness, confusion, and abdominal
pain are indicators of digoxin toxicity.
The nurse recognizes which of the following factors for Mary Richards as
contributing to the risk for digoxin toxicity? (Select all that apply.)
Age, Prescription for diuretic, Vomiting and diarrhea
Rationale:Patients over the age of 80 may be at higher risk of digoxin toxicity due to
normal renal changes that occur with advanced age. Digoxin toxicity can be caused by
electrolyte disturbances, such as potassium depletion, caused by concurrent use of
diuretics. GI fluid loss via vomiting and/or diarrhea may lead to potassium losses, which
will increase digoxin levels. The other answer choices do not place Mary Richards at an
increased risk for digoxin toxicity.
The nurse is preparing to administer digoxin 0.25 mg and furosemide 40 mg to a
patient. The patient reports seeing yellow halos around the lights in the room.
Which of the following is the priority action for the nurse to take?
Withhold the digoxin
Rationale:Presence of yellow halos is a symptom of digoxin toxicity. The nurse should
withhold digoxin. Potassium would only be administered if laboratory values indicate.
Verifying furosemide dose and assessing blood pressure are not priority actions based
on the patient's symptoms.
