A patient who takes spironolactone for heart failure has begun taking digoxin (Lanoxin) for atrial fibrillation. The primary care NP provides teaching for this patient and asks the patient to repeat back what has been learned
Which statement by the patient indicates understanding of the teaching? a. "I should avoid high-sodium foods."
b. "I should eat foods high in potassium."
c. "I need to take a calcium supplement every day."
d. "I should use a salt substitute while taking these medications."
A
Patients should be taught to reduce their overall sodium intake by avoiding salty foods and not adding salt while cooking. Spironolactone is a potassium-sparing diuretic and carries a risk of hyperkalemia, which can make the myocardium more sensitive to the effects of digoxin. Hypercalcemia can predispose the patient to digoxin toxicity. Salt substitutes are high in potassium.
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