Test-Taking Tip

Since the main action of the drug is to slow the heart rate, the nurse should monitor the heart rate for signs of toxicity. The best answer is based upon the key safety parameter for this medication.

Content Area: Child Health, Cardiovascular; Integrated Process: Nursing Process, Implementation; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Medication Administration

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Health Promotion and Maintenance

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Answer 1 is correct because the apical heart rate must always be obtained by the nurse prior to the administration of digoxin (Lanoxin) to a child. Unless otherwise prescribed, the medication is typically withheld for a heart rate below 90 to 110 bpm in young children. Answer 2 is incorrect because, although the potassium level may be affected by the combined administration of digoxin (Lanoxin) with diuretics, the most important nursing action is to determine whether the apical heart rate meets the parameter for safe digoxin (Lanoxin) administration. Answer 3 is incorrect because the heart rate and not the ECG waveform should be assessed prior to digoxin (Lanoxin) administration. Answer 4 is incorrect since mixing the medication with a food or fluid is generally unnecessary due to the medication's sweet taste. Additionally, mixing with foods/fluids poses the risk that the child will refuse the mixture and the nurse may be unable to determine how much medication the child ingested.

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