The nurse is preparing to administer digoxin to a patient who has ...

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The nurse is preparing to administer digoxin to a patient who has a serum digoxin level of 2.5 ng/mL. The patient takes 0.25 mg of digoxin per day. What action will the nurse take?
 
  a. Administer the next dose as ordered.
  b. Notify the provider of digoxin toxicity.
  c. Request an order to decrease the digoxin dose.
  d. Suggest that the patient may need an increased digoxin dose.

Question 2

A patient who has Wolff-Parkinson-White syndrome is given intravenous adenosine (Adenocard). The nurse will explain that the medication is effective because it
 
  a. controls atrial flutter.
  b. deepens myocardial excitability.
  c. prevents multifocal ventricular contractions.
  d. prolongs repolarization.

[jsm54321]

Answer to Question 1

ANS: B
The therapeutic range of digoxin is between 0.5 and 2 mg/mL. This patient's level is high, indicating toxicity. The nurse should not give the next dose or request a change in dose.

Answer to Question 2

ANS: D
Adenosine is a class III drug that prolongs repolarization by increasing the refractory period and prolonging the action potential to slow heart rate. It does not control atrial flutter, deepen myocardial excitability, or prevent multifocal contractions.

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Excellent

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