A patient has an elevated BUN and creatinine. The patient has been prescribed digoxin (Lanoxin) for heart failure. What aspect of care is the priority regarding this patient?
A) The patient should be taught to increase sodium in her diet.
B) The dose should be increased when her heart rate is below 60.
C) The dose should be decreased in this patient.
D) The dosage should be 1.0 mg PO daily.
C
Feedback:
The dose must be reduced in the presence of renal failure because most of the digoxin is excreted unchanged by the kidneys, leading to drug accumulation and toxicity. The patient should be taught to limit sodium intake in the diet. The patient's heart rate should remain above 60 . If the heart rate falls below 60, the digoxin should be held. The dose of 1.0 mg is too large for a patient with altered renal function.
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