A patient with heart failure who has been given digoxin [Lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will:
a. assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute.
b. contact the provider to report digoxin tox-icity.
c. request an order for a decreased dose of digoxin.
d. review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L.
A
Anorexia, nausea, and vomiting are the most common adverse effects of digoxin and should cause nurses to evaluate for more serious signs of toxicity. If the HR is greater than 60 beats per minute, the dose may be given. Nausea by itself is not a sign of toxicity. A decreased dose is not indicated. A serum potassium level less than 3.5 mEq/L is an indication for withholding the dose.
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