Question

A nurse is collecting data prior to administering digoxin to a client. For which of the following findings should the nurse withhold this medication and notify the provider?

A. Digoxin level 0.9 ng/mL
B. Blood pressure 142/80 mm Hg
C. Potassium 4.4 mEq/L
D. Apical pulse 52/min

Answer 1

The nurse should withhold digoxin and notify the provider if the client has an apical pulse of 52/min, as this is below the normal threshold and could indicate an increased risk for digoxin toxicity.

Step-by-step explanation:

When a nurse is collecting data before administering digoxin, it is crucial to check specific parameters, as digoxin is a medication with a narrow therapeutic range and can be toxic if not properly managed. The nurse should withhold the medication and notify the provider if there is an abnormally low apical pulse, indicative of bradycardia, or an elevated digoxin level indicating potential toxicity. Of the choices provided:

• A digoxin level of 0.9 ng/mL is within the therapeutic range.
• A blood pressure of 142/80 mm Hg is elevated but not critical in most circumstances.
• A potassium level of 4.4 mEq/L falls within the normal range.
• An apical pulse of 52/min is below the typical threshold (usually less than 60/min may be a reason to withhold digoxin and report to the provider).

Therefore, option D, Apical pulse 52/min, is the correct answer. The apical pulse rate is concerning and could indicate an increased risk for digoxin toxicity or other cardiac complications, which is why the nurse should withhold the medication and contact a healthcare provider.