MEDizzy - A client takes digoxin with the loop diuretic furosemide

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Pharmacological Therapies VII

A client takes digoxin with the loop diuretic furosemide (Lasix).This morning the client complains of anorexia and nausea. The client vomited once yesterday. What should the nurse do first?

ExplanationDigoxin toxicity is evidenced by anorexia, nausea, and vomiting, as well as visual changes. (The first and most likely concern is due to narrow safety range.) Loop diuretics can cause significant renal potassium losses. Digoxin administration can cause hypokalemia, which can lead to life-threatening arrhythmias. This client requires a digoxin level and a potassium level, which can be obtained from an electrolyte panel. The electrolyte panel also provides the physician with a more complete picture of this client’s electrolyte status. Choices 1 and 2 provide no data regarding digoxin toxicity or electrolyte status. Choice 4 is important but omits the necessary digoxin-level information.