Question

A patient has been taking digoxin (Lanoxin) 0.25 mg, and furosemide (Lasix) 40 mg, daily. Upon routine assessment by the nurse, the patient states, "I see yellow halos around the lights." The nurse should perform which action based on this assessment?

a. Check the patient for other symptoms of digitalis toxicity.
b. Withhold the next dose of furosemide.
c. Continue to monitor the patient for heart failure.
d. Document the findings and reassess in 1 hour.

Answer 1

The nurse should check the patient for other symptoms of digitalis toxicity when they report seeing yellow halos around lights. This symptom is a classic indication of digoxin toxicity, which needs immediate attention and assessment for other related symptoms.

Step-by-step explanation:

If a patient reports seeing yellow halos around lights while taking digoxin (Lanoxin) and furosemide (Lasix), the nurse should perform which action based on this assessment? The correct action would be to check the patient for other symptoms of digitalis toxicity. Seeing yellow halos is a classic sign of digoxin toxicity, and further assessment for additional signs and symptoms of toxicity should be conducted immediately. These can include gastrointestinal distress, confusion, irregular heartbeat, and other visual changes. Digoxin has a narrow therapeutic window, making it critical to monitor for any indications of overdose.

Withholding the next dose of furosemide would not be appropriate solely based on the visual disturbance, as furosemide does not typically cause these symptoms. Continual monitoring for heart failure is important but would not directly address the immediate concern of digoxin toxicity. While documentation is an essential component of nursing care, the nurse would first need to perform a thorough assessment for other signs of toxicity before documenting and waiting to reassess.