A 70-year-old patient who has been taking digoxin (Lanoxin) for 4 years has all of the following laboratory blood tests. For which test value does the nurse notify the prescriber immediately?
a. Sodium (Na) 132 mEq/L
b. Potassium (K) 2.1 mEq/L
c. Blood urea nitrogen (BUN) 9 mg/dL
d. International normalized ratio (INR) 1.5
B
Although all of these values are abnormal, only the potassium level is dangerously out of the normal range (it is low, indicating hypokalemia; normal is 3.5 to 5 mEq/L). Abnormal potassium levels change the effectiveness of digoxin. In the case of hypokalemia, the sensitivity of the car-diac muscle membrane is increased to the effects of digoxin. This means that the risk for toxicity is greatly increased. The prescriber will probably order a digoxin level and lower the dosage of the drug.
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