A client is prescribed a loading dose of a cardiac glycoside for an exacerbation of heart failure. When the client comments, "I usually take a much lower dose," which response by the nurse is the most appropriate?

Question

1. "Giving a large dose will reduce the incidence of side effects."
2. "You are being given a large dose in order to increase blood levels of the drug quickly."
3. "The health care provider ordered this dose, so I need to administer it."
4. "Your usual dose is probably no longer effective for your condition, and you need to be on a higher dose now."

Answer 1

Correct Answer: 2
Rationale 1: Giving a larger dose actually could increase the incidence of side effects.
Rationale 2: Loading doses of medications are used to provide a more rapid increase in the blood level of the drug, resulting in a quicker therapeutic response.
Rationale 3: Although this is an accurate statement, it does not provide an explanation to the client as to why a larger dose is being administered.
Rationale 4: A loading dose is usually only given once, and the client will then be put back on the average daily dose.
Global Rationale: Loading doses of medications are used to provide a more rapid increase in the blood level of the drug, resulting in a quicker therapeutic response. Giving a larger dose actually could increase the incidence of side effects. Although the health care provider did order the dose, it does not provide an explanation to the client as to why a larger dose is being administered. A loading dose is usually only given once, and the client will then be put back on the average daily dose.