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Pediatrics II

The nurse is administering the daily digoxin dose of 0.035 mg to a 10-month-old child. Before administering the dose, the nurse takes the child’s apical pulse, and it is 85. Which of the following interpretations of these data is most accurate?

The child has just awakened, and the heart action is slowest in the morningThis is a normal rate for a 10-month-old childThe child may be going into heart block due to digoxin toxicityThe child’s potassium level needs to be evaluated

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ExplanationA pulse below 100 in a 10-month-old child who is taking digoxin most likely indicates digoxin toxicity. The nurse should withhold the medication and notify the physician. The normal pulse for this age is about 120 or a little more at rest. The pulse rate does not tell us that the child needs to have his/her potassium level checked. If the child is also taking Lasix or another potassium-depleting diuretic, then the potassium should be checked.

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