Question

A nurse is providing care to an older adult client with newly diagnosed heart failure. The nurse receives a prescription for digoxin PO 1.5 mg daily. Which action does the nurse perform next?

Instruct the client to take the heart rate before administration

Educate the client on the purpose of digoxin

Administer the medication to the client

Clarify the prescription with the healthcare provider

Answer 1

The nurse should clarify the prescription with the healthcare provider since 1.5 mg daily of digoxin for an older adult with heart failure is typically considered a high starting dose, thus raising concern for potential toxicity.

Step-by-step explanation:

When caring for a client with newly diagnosed heart failure and who has been prescribed digoxin, the nurse should first clarify the prescription with the healthcare provider. The initial dosage of 1.5 mg daily of digoxin seems high, as it is typically started at a lower dose to avoid toxicity, especially in older adults. Digoxin is a cardiac medication that helps strengthen the contraction of the heart muscle, slows the heart rate, and improves symptoms of heart failure. Given the potential for digoxin toxicity and harmful side effects like bradycardia, which can lead to heart stoppage (especially when prescribed alongside other medications like beta blockers that also decrease heart rate), it is crucial to ensure the correct dosage before administration.