about digoxin level?

1. the question is
   
   When a nurse is preparing a scheduled dose of digoxin for an adult patient, the lab results indicate that the plasma level of digoxin is 1.5 ng/mL. Should the nurse:
   a. withhold the drug and notify the health care provider immediatley.
   b. withhold the drug and notify the health care provider during rounds.
   c. administer Digibind to counteract the toxicity.
   d. check the client's pulse and if it is greater than 60 beats per minute,
   administer the dose of digoxin.
   
   In my source on digoxin, it states that therapeutic serum levels are 0.5 to 2.0 nanograms/milliliter. In the elderly the therapeutic serum level is between 0.5 and 1.3 ng/mL.
   But later in the source, there is a research summary in which the authors state that their findings suggest that serum levels, for men and women, must be kept as low as possible (0.5 to 1 ng/m).
   The source is a course textbook for pharmacology.
   Is the therapeutic range 0.5 to 1 ng/mL or 0.5 to 2 ng/mL?
   
   I was going to select d, but after reading the research summary, then I wondered if a is correct?

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2. 10 Comments

   Topic Closed
3. 
   Jul 11, '06

   You're reading into the question...just take it at face value and go with "d"
4. 
   Jul 11, '06

   According to my saunders book the normal perameters for Dig is 0.5-2.0. I would select (d). Maybe someone else has some differnet information about this, guess we will wait and see
5. 
   Jul 11, '06

   D would be my choice also....norms I learned were from 0.5-2.0
6. 
   Jul 11, '06

   mosby's book says normal value is 0.5-2.5 ng/ml..i guess that would be d.
7. 
   Jul 11, '06

   maybe if the authors had included more than one research study with similar findings - then their conclusion that 0.5 to 1.0 ng/mL is the therapeutic range would be stronger?
8. 
   Jul 11, '06

   "D" is the correct answer. Always go with what you know to be true.:spin:
9. 
   Jul 12, '06

   D is what I would choose.
10. 
    Jul 12, '06

    My answer would be letter D... according to Kaplan therapeutic level of digoxin is .5-2ng/ml.. it is so confusing if you look at different books because they have different normal levels.
11. 
    Jul 12, '06

    it also depends on your hospital policy. my hospital has set specific levels for lab values so what i would do would depend on that, not what the books say. but i would probably pick D. and then make sure the MD knows the level is climbing. but they never have the real life answer.
    
    just a quick pet peeve...i hate it when those school questions say "notify the health care provider". i'm a health care provider. you're a healthcare provider. OT is a healthcare provider. let's be honest...you notify the MD. but that has nothing to do with anything....it's just my own pet peeve. lol.
12. 
    Jul 12, '06

    D
    
    Oh I am having flashbacks of nursing school! :spin:

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