A physician prescribes digoxin 1.25 mg PO daily for a client with heart failure. The client’s serum digoxin level is 2.8 ng/mL. What should the nurse do before administering the medication?
Administer a reduced dose of 0.625 mg after documenting the digoxin level.
Administer the ordered dose and monitor the client’s heart rate more closely.
Hold the medication and notify the prescribing physician.
Administer the medication as ordered and reassess the client after 4 hours.
Digoxin levels above 2.0 ng/mL are generally considered toxic and can lead to complications such as bradycardia, nausea, and visual disturbances. Administering the medication without addressing the elevated digoxin level would pose a serious risk to the client. The nurse should hold the dose and immediately notify the prescribing physician to reassess the order. Simply administering a lower dose or doubling the monitoring frequency is not within the nurse's scope without consulting the provider, and administering the full dose could worsen toxicity symptoms.
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Physiological Integrity
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