CARDIAC GLYCOSIDE UNIT 6 CHPT 37 Flashcards
Which of the following drugs is a Cardiac Gycosides?
A. Dilitizem
B. Digoxin
C. Diphenhydramine
D. Albuterol
B. Digoxin
What is the use of Digoxin
To treat heart failure, atrial fibrillation
Mechanism of Action: Inhibits sodium-potassium ATPase, promoting increased force of cardiac contraction, cardiac output, and tissue perfusion; decreases ventricular rate
IT LOWERS THE HEART RATE AND CONTRACTS THE HEART MORE POWERFULLY
Side effects of digoxin
Dizziness, weakness, headache
What are the signs of toxicity of Digoxin
Bradycardia, cardiac dysrhythmias
* Anorexia, nausea, vomiting, diarrhea
* Blurred vision, yellow or green halos around objects
* Digoxin toxicit
Is potassium levels crucial to the use of Digoxin
Yes, A low level of potassium in the body can increase the risk of digitalis toxicity. Digitalis toxicity may also develop in people who take digoxin and have a low level of magnesium in their body.
Should you give digoxin to a patient with a heart rate less than 60?
No
Assessment for Digoxin
Assessment
* Obtain a baseline pulse rate for future comparisons. Apical
pulse for one minute
* Medical/medication history
* Electrolytes (Pottassium)
* Signs and symptoms of CHF/atrial arrhythmia/edema/lung
sounds
* Assess for evidence of digitalis toxicity
What is therapeutic range for Digoxin?
Monitor serum digoxin level – 0.5-2ng mL. Toxic is over 2.2
ng/mL
2 IS TOO TOXIC MINITOR FOR GREEN YELLOW HALOS REPORTED BY PATIENT SIGNS OF TOXICITY
- Assess for signs and symptoms of digitalis toxicity. Common symptoms include anorexia, nausea, vomiting, bradycardia, cardiac dysrhythmias, and visual disturbances. Report symptoms immediately to the health care provider.
Bradycardia, cardiac dysrhythmias
* Anorexia, nausea, vomiting, diarrhea
* Blurred vision, yellow or green halos around objects
* Digoxin toxicit
Nursing Interventions and Patient Teaching for Digoxin
Nursing interventions
Monitor serum digoxin level – 0.5-2ng mL. Toxic is over 2.2
ng/mL
Monitor serum potassium level and report if hypokalemia.
Monitor edema/signs and symptoms of CHF, pulse
- Teaching
- Take drug same time every day
- Take pulse and notify HCP if less than 60 above 100
- S/S to report, for example s/s of dig toxicity
- If taking diuretic take potassium supplement as prescribed
Evaluation – how do we know its working?
NURSING PROCESS: DIGOXIN
- The patient is receiving digoxin for treatment of heart failure. Which finding would suggest to the nurse that the heart failure is improving?
a. Pale and cool extremities
b. Absence of peripheral edema
c. Urine output of 60 mL every 4 hours
d. Complaints of increasing dyspnea
b. Absence of peripheral edema
- The patient’s serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin level?
a. It is in the high (elevated) range.
b. It is in the low (decreased) range.
c. It is within the normal range.
d. It is in the low-average range.
a. It is in the high (elevated) range.
- The nurse is assessing a patient for possible evidence of digitalis toxicity. Which of these is included in the signs and symptoms for digitalis toxicity?
a. Apical pulse rate of 100 beats/min
b. Apical pulse of 72 beats/min with an irregular rate
c. Apical pulse of 90 beats/min with an irregular rate
d. Apical pulse of 48 beats/min with an irregular rate
d. Apical pulse of 48 beats/min with an irregular rate
- A patient is taking a potassium-depleting diuretic and digoxin. The nurse expects that a low potassium level (hypokalemia) could have what effect on digoxin?
a. Increases serum digoxin sensitivity level
b. Decreases serum digoxin sensitivity level
c. No effect on serum digoxin sensitivity level
d. Causes a low-average serum digoxin sensitivity level
a. Increases serum digoxin sensitivity level
When ever potassium is low Digoxin becomes high to a toxicity level out of the 0.5- 2 mg range
