Question

An elderly client with chronic heart failure (HF) has been treated with digoxin 0.25 mg QD PO, furosemide 80 mg QD PO, potassium chloride 20 mEq QD PO. During morning rounds, the client complains of nausea, no appetite and that the lights are so bright and blurry. The nurse is preparing him for transfer back to the nursing home.

Vital signs: T 98, P 62, RR 18, BP 112/70, apical HR 60, SpO₂ 94% on room air. Digoxin level is 1.5 ng/mL. (20 points each)

• Explain why the client is prescribed potassium chloride.
• Determine whether the nurse should administer the scheduled dose of digoxin, and why or why not.

Answer 1

Answer.. The patient is receiving digoxin therapy. The most common cause for digoxin toxicity is hypokalemia,it is due to diuretic therapy. In this case patient is getting furosemide 80mg daily along with digoxin.so more prone to get hypokalemia. So the patient is prescribed with potassium chloride.

If the patient is on treatment for heart failure the normal level of digoxin is 0.5 to 0.9ng/mL. The patient serum digoxin level is 1.5ng/ml.As the patient is receiving treatment for heart failure, this is in above the therapeutic range of 0.5 to 0.9ng/dl. So nurse can't administer the scheduled dose of digoxin.