Nursing 211

N211: Health Differences Across the Lifespan I

Nursing Implications Monitor serum electrolytes; hypokalemia increases risk of digitalis toxicity Monitor serum digitalis levels if any side effects are present Check apical pulse prior to administration, hold if <60 bpm Teach client to take radial pulse prior to administration Therapeutic range is 0.5-2 mg



Adverse Reactions Severe AV block Headache Dysrthymias Nausea Vomiting Blurred vision Yellow green halos Hypotension Fatigue

Heart failure Increased contractility of cardiac muscle Slows heart rate and conduction Antidote for digitalis toxicity Binds with digoxin or digitoxin to prevent binding at their site of action

Digitoxin Digoxin

Digoxin-Immune Fab (Digibind) Decreased cardiac output Atrial tachydysrhythmias Use cautiously with older adults and children Use with 0.22um filter Place client on continuous monitor Have resuscitation equipment at bedside before giving first dose Side effects of digoxin are increased when the client is hypokalemic. Digitalis has a negative chronotropic effect; it slows the heart rate. Hold digitalis if the pulse rate is <60 or >120 bpm. In infants hold medication if pulse is <90 bpm. Bradycardia, tachycardia and dysrhythmias, nausea, vomiting, headaches may be signs of digitalis toxicity. 1.10 Dysrhythmias


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