Question

A nurse is caring for a client who presents to the clinic for a 1-week follow-up visit after hospitalization for heart failure.

Exhibit question

Prescriptions
Digoxin 0.25 mg PO daily
Furosemide 40 mg PO daily
Potassium chloride 20 mEq/L PO daily

History and physical

Discharge:
Weight 66.7 kg (147 lb)
SaO2 94%
2+ pedal edema
Heart rate 74/min

Current:
Weight 67.1 kg (148 lb)
SaO2 92%
1+ pedal edema
Heart rate 55/min

Based on the information in the client's chart, which of the following findings should the nurse report to the provider?

Potassium 4.1 mEq/L

Heart rate 55/min

SaO2 92%

Weight 67.1 kg (148lb)

Answer 1

The nurse should report the heart rate of 55/min to the provider.

Step-by-step explanation:

The heart rate is a critical parameter in assessing cardiovascular health, and a rate of 55/min is below the typical range, especially considering the client's history of heart failure. The significant decrease in heart rate from 74/min at discharge to 55/min during the follow-up suggests the possibility of bradycardia, which can be associated with digoxin use. Bradycardia can lead to decreased cardiac output and exacerbate heart failure symptoms. The nurse should promptly report this finding to the provider for further evaluation and potential adjustment of the medication regimen.

While other parameters, such as a potassium level of 4.1 mEq/L, SaO2 of 92%, and a weight increase to 67.1 kg, are noteworthy, they do not present an immediate concern or deviation from the expected values. The potassium level is within the normal range, and the weight gain is relatively minimal. SaO2 at 92% may indicate some decrease in oxygen saturation, but it alone might not warrant urgent intervention. The priority lies in addressing the bradycardia as it can have immediate implications for the client's cardiovascular stability. Reporting this finding ensures timely intervention to prevent potential complications and optimize the client's overall well-being.