Question

A patient with congestive heart failure is admitted to the hospital. During the admission assessment, the nurse learns that the patient is taking a thiazide diuretic. The nurse notes that the admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of 95 mEq/L, and a potassium level of 3 mEq/L. The prescriber has ordered digoxin to be given immediately. What will the nurse do initially?

a. Give the digoxin and maintain close cardiac monitoring.
b. Hold the digoxin and report the laboratory values to the provider.
c. Hold the thiazide diuretic and give the digoxin.
d. Request an order for an electrocardiogram (ECG).

Answer 1

The nurse should hold the digoxin and report the laboratory values to the provider. A low potassium level can increase the risk of digoxin toxicity.

Step-by-step explanation:

The nurse should hold the digoxin and report the laboratory values to the provider (Option b). A potassium level of 3 mEq/L is considered low and can increase the risk of digoxin toxicity. Digoxin is a medication used to treat heart failure, but it has a narrow therapeutic range, meaning that too high a dose can lead to toxicity. It is important to ensure that the patient's electrolyte levels, especially potassium, are within the normal range before administering digoxin.

By holding the digoxin and notifying the provider, the nurse allows the provider to reassess the patient's condition and determine the appropriate course of action. This may involve adjusting the digoxin dose, addressing the low potassium level, or considering alternative treatment options.