Kaplan Trainer 5 - Question 68 (Digoxin)

Published

So if a patient has a plasma level of 2.0 we should withhold the medication??? I figured if the therapeutic level is 0.5 to 2.0, then 2.0 is still therapeutic, especially since it's a maintenance dose. If the dose is withheld, wouldn't the level drop?? Please share your opinion, but I think this question is poorly written.

  • order for digoxin (Lanoxin) 25 mg PO daily
  • apical pulse 68/min
  • respirations 16/min
  • plasma digoxin level 2 ng/ml

  • which of the nursing action is appropriate?

  1. 1. Give the medication on time.
  2. 2. Withhold the medication; notify the physician.
  3. 3. Administer epinephrine 1:1,000 stat.
  4. 4. Check the client's blood pressure.

(1) medication should be withheld

(2) correct-therapeutic plasma level of digoxin is 0.5-2.0 ng/ml

(3) not a correct action

(4) assessment, does not address the issue of the elevated blood level of digoxin

Up Vote Up Vote ×

If you give more Digoxin, the serum will get higher than 2.0 ng/ml.

Up Vote Up Vote ×

but if you withhold it, is there a possibility that it would fall below the therapeutic range? it's a maintenance dose... so shouldn't it 'maintain' the level at 2.0 given the schedule and half-life?

Up Vote Up Vote ×

Just did that same question!! I actually got a question in a Qbank wrong today and ended up getting this question right b/c of it. It was about Lithium being at the level of 1.5 mEq, what should you do...(notify doc). Just remember when drugs are at their max therapeutic levels you should question the dosage b/c giving more of the drug will result in higher levels in the body...now I see why they say to read each and every rationale!

Good luck and just keep answering questions. Kaplan is kicking my butt, I have 2 trainers left and about 30% of the Qbank to complete.

Up Vote Up Vote ×

Remember, keeping your patient safe in the HERE AND NOW! Giving the drug at that moment will increase the level and then you have put your patient in a potential predicament.

Up Vote Up Vote ×

If you withhold the dose, yeah the serum level may drop a little bit (I doubt it would go below the therapeutic range, but even if it did, it's not toxic).

If you give the med, the serum WILL go above 2 ng/ml.

Google Digoxin Toxicity. It's bad stuff.

Up Vote Up Vote ×

thanks for the replies... hopefully I get something like this on my actual NCLEX so I can kick NCLEXs @SS!! :p

Up Vote Up Vote ×

LOL! You definitely won't forget it! How soon are you testing?

Up Vote Up Vote ×

19 days, 20 hours, 9 minutes and counting

Up Vote Up Vote ×

Also remember--Dig Toxicity = Diarrhea and seeing halos (my Kaplan instructor said it like 1800 times) :lol2:

Up Vote Up Vote ×

now i pray for a Dig question.... BRING IT ON!! hahaha

Up Vote Up Vote ×

I remember when my test was that far away, OMG, it's so close now. I'm just ready to get the experience behind me already, eek!

Up Vote Up Vote ×
+ Join the Discussion