Question

A patient who is taking digoxin (lanolin) is admitted to the hospital for treatment of congestive heart failure. the prescriber has ordered furosemide (Lasix) to be given. the nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mmHg. which priority assessment would cause the nurse to hold the furosemide (Lasix) and call the prescriber?

a. a potassium level of 3.1 mEq/L
b. a change in blood pressure to 124/80mmHg after sitting up
c. an increase in respiration to 24 breaths per minutes after 20 minutes
d. a sodium level of 145 mEq/L

Answer 1

The priority assessment that would cause the nurse to hold the furosemide (Lasix) and call the prescriber is a potassium level of 3.1 mEq/L. This condition, known as hypokalemia, is critical because furosemide can worsen it, increasing the risk of serious arrhythmias due to digoxin toxicity.

Step-by-step explanation:

A patient taking digoxin (Lanoxin) and admitted for treatment of congestive heart failure has been ordered furosemide (Lasix). However, the nurse should be particularly cautious if a potassium level of 3.1 mEq/L is noted, which is indicative of hypokalemia. Furosemide is a loop diuretic and can further lower potassium levels, potentially causing serious arrhythmias in conjunction with digoxin, which has a narrow therapeutic window and is affected by potassium levels. In this case, the nurse would hold the furosemide and call the prescriber because hypokalemia can exacerbate digoxin's effect on the heart and increase the risk of digoxin toxicity.