A patient with heart failure is prescribed digoxin (Lanoxin). The patient reports nausea, blurry vision, and feeling like the heart is skipping beats. What is the nurse's best action?
a. Administer the scheduled dose because it will correct these side effects.
b. Assess the patient's heart rate and then administer the scheduled dose.
c. Hold the dose and notify the prescriber immediately.
d. Place the patient on complete bed rest.
C
Nausea, blurry vision, and heart rate or rhythm changes are signs of digoxin overdose. The dose should be held and the prescriber notified. Most likely the nurse will also obtain a blood sample to measure the digoxin level. Digoxin has a very narrow therapeutic range (0.8 to 2 ng/mL) and this level should be checked whenever a patient shows any signs of toxicity. Symptoms usually resolve when the drug is held and the body eliminates it.
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