An older adult client recently started digoxin (Lanoxin) and is in the office for a routine checkup. Lab tests show a decline in the client's renal function. Which is a priority concern for the nurse based on the lab results?

Question

1. Digoxin causing the decrease in renal function.
2. Digoxin interfering with the lab test, making it appear that the client's renal function has worsened.
3. Increased likelihood of toxicity due to the inability to excrete digoxin.
4. Diminished response to digoxin due to alterations in pharmacodynamics.

Answer 1

Correct Answer: 3
Rationale 1: Digoxin does not cause decreases in renal function.
Rationale 2: Digoxin does not interfere with laboratory tests of renal function.
Rationale 3: Digoxin is largely eliminated by the kidneys. Serious toxicity can occur if the dose is not adjusted after a decline in renal function.
Rationale 4: Changes in renal function do not affect the pharmacodynamics of digoxin.