Question

6. Why should the nurse assess Shirley for digitalis toxicity? List the signs and symptoms of digitalis toxicity. What is the normal blood therapeutic range of digitalis? y was referred to the he alth care provider because of her serum potassium deficits and ita effects on digitalis. A repeat potassium was completed, and the result was 2.8 mEg/L. A liter of 5% Dextrose in water with KCL 40 mEq was administered over four hours. 7. How many milliequivalents of KCL per hour would the patient receive? Does this amount constitute an acceptable dosage? Why is it important for the nurse to monitor the rate of intravenous fluids containing potassium, the hourly urine output, and the vital signs? 8. 9. Because of the low serum potassium level, what other electrolytes values should be fter Shirley's serum electrolytes retuned to normal, the health care provider instructed her to 10. Shirley asks why she has to continue taking these drugs. What is the nurse's best checked? Explain your answer. ontinue taking the prescribed KCL dosage daily with her other medications. 11. The nurse instructs Shirley to eat foods rich in potassium. Prepare a list of foods that are richest in potassium 12/18

case study- heart failure- potassium/digoxin

Answer 1

6. Digitalis is a cardiac glycoside . It is a positive ionotropic ,negative chronotropic and dromotrophic drug . Positive ionotropic means increases the heart contractility , negative chronotropic means decreases the heart rate and negative dromotrophic means decreases the decreases the conductivity.

The nurse has suspected or assessed for digitalis toxicity because Shirley is taking furesomide and digoxin simultaneously. In hypokalemia , digoxin toxicity occur more easily . In a heart failure patient ,patient is given diuretics ,it inhibits the reabsorption of potassium from renal tubules and causes hypokalemia and chances of digoxin toxicity increases .

# Side effects of digoxin toxicity are :-

- anorexia (first sign)

- confusion

- blurred vision

- diarrhea

- nausea

- vomiting

- irritability

- haloes

- yellow/green colours

- seeing spots

- blind spots

# The normal therapeutic level of digoxin is 05- 2 ng/dl

7. After a repeat potassium level assessment (2.8mEq/l) , 40mEq of kcl was administered in 5%dextrose over 4 hours.

The milliequivalent of kcl per hour will be 10mEq (40mEq÷4hours ) . Yes it's the acceptable dosage ,if serum potassium is 2.5 mEq/L or higher, rate should not exceed 10 mEq/hour

8. It is important to monitor the vital signs ,urine output and continuous potassium infusion because of the following reasons :-

Monitor her vital signs, cardiac rhythm, and respiratory rate, depth, and pattern. Immediately notify the health care provider if his respirations become shallow and rapid.

Perform continuous cardiac monitoring if her serum potassium level is less than 3 mEq/L or greater than 6 mEq/L. She may need aggressive treatment to prevent cardiac arrest.

Monitor and document her fluid intake and output. Diuresis can put her at risk for potassium loss, and inadequate excretion may lead to dangerously high potassium levels. Report oliguria or polyuria.

Monitor her serum potassium levels to assess her response to treatment.

9. The other electrolyte to be checked is sodium . Because in this case the nurse is suspecting for digoxin toxicity . Digoxin toxicity leads to dehydration by causing diarrhea ,vomiting and also the patient is taking a low sodium diet . All this leads to loss of sodium from the body .