Digoxin – Pharmacology for Nurses: Practical Applications

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Chapter 24: Heart Failure Drugs Test, Digoxin – Pharmacology for Nurses: Practical Applications

The key terms in this Pharmacology course include Heart Failure Drugs, Nurse, Patient, Digoxin – Pharmacology for Nurses: Practical Applications

The nurse reviews an adult patient’s laboratory values and notes a digoxin level of 11 ng/mL and a serum potassium level of 6.2 mEq/L. The nurse would notify the health care provider and anticipate which medication will be prescribed to administer?

Sodium polystyrene sulfonate


Digoxin immune Fab


Digoxin immune Fab is indicated for severe digoxin toxicity in patients with the following clinical findings: hyperkalemia (serum potassium level higher than 5 mEq/L) with digoxin toxicity; life-threatening digoxin overdose (more than 10 mg digoxin in adults; more than 4 mg digoxin in children); and life-threatening cardiac dysrhythmias, sustained ventricular tachycardia or fibrillation, and severe sinus bradycardia or heart block unresponsive to atropine treatment or cardiac pacing.

Which are therapeutic effects of digoxin?

Negative inotropic, negative chronotropic, and negative dromotropic

Positive inotropic, negative chronotropic, and negative dromotropic

Positive inotropic, negative chronotropic, and positive dromotropic

Positive inotropic, positive chronotropic, and negative dromotropic

Digoxin increases cardiac contractility (positive inotropic effect), decreases heart rate (negative chronotropic effect), and decreases conductivity (negative dromotropic effect).

The nurse is preparing to administer digoxin 0.25 mg intravenous push to a patient. Which is an expected patient outcome related to the administration of digoxin?

Increase in blood pressure

Reduction in urine output

Decrease in the heart rate

Low serum potassium

Digoxin has a negative chronotropic effect (decreased heart rate).

A patient weighing 44 lb is prescribed a digoxin loading dose of 0.03 mg/kg to be administered in three divided doses. How much will the nurse administer in each dose?  Must be entered as x.x mg for your answer to be read. 

0.3 mg

0.6 mg

0.4 mg

0.2 mg

44 lb is converted to kilograms by dividing 44 by 2.2 kg = 20 kg. 0.03 mg/kg × 20 kg = 0.6 mg. 0.6 mg ÷ 3 doses = 0.2 mg/dose.

The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. The nurse will teach the patient to avoid which foods when taking the digoxin?

Grapefruit juice

Leafy green vegetables

Bran muffins

Dairy products

Bran, in large amounts, may decrease the absorption of oral digitalis drugs. The other foods do not affect digoxin levels.

In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?

Potassium level 2.8 mEq/L

Sodium level 140 mEq/L

Calcium level 10 mg/dL

Potassium level 4.9 mEq/L

Hypokalemia increases the chance of digitalis toxicity. The other levels listed are incorrect.