DIGOXIN.pdf - ACTIVE LEARNING TEMPLATE Medication MARIN MCBRIDE STUDENT NAME DIGOXIN MEDICATION REVIEW MODULE CHAPTER_20 GLYCOSIDES CATEGORY

DIGOXIN.pdf - ACTIVE LEARNING TEMPLATE Medication MARIN...

This preview shows page 1 out of 1 page.

You've reached the end of your free preview.

Want to read the whole page?

Unformatted text preview: ACTIVE LEARNING TEMPLATE: Medication MARIN MCBRIDE STUDENT NAME______________________________________ DIGOXIN MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER__20 __________ GLYCOSIDES CATEGORY CLASS__CARDIAC _____________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action ●Positive inotropic effect: increased force of myocardial contraction ●Negative chronotropic effect: decreased heart rate Therapeutic Use ●As a second‑line medication -Heart failure -Dysrhythmias (atrial fibrillation) -Can reduce manifestations, but does not prolong life Complications ● Dysrhythmias (caused by interfering with the electrical conduction in the myocardium) ● Cardiotoxicity leading to bradycardia ● GI effects (anorexia [usually first sign], nausea, vomiting, abdominal pain) ● CNS effects (fatigue, weakness, vision changes [diplopia, blurred vision, yellow-green or white halos around objects]) Contraindications/Precautions ●Pregnancy Risk Category C ● Disturbances in ventricular rhythm (ventricular fibrillation, ventricular tachycardia, second‑ and third‑degree heart block) are contraindications for receiving digoxin. ● Clients who have hypokalemia, partial AV block, advanced heart failure, or impaired kidney function require caution with digoxin therapy. Interactions ● Thiazide diuretics (such as hydrochlorothiazide) and loop diuretics (such as furosemide) can lead to hypokalemia, which increases the risk for developing dysrhythmias. ● ACE inhibitors and ARBs increase the risk of hyperkalemia, which can reduce the therapeutic effects of digoxin. ● Sympathomimetic medications such as dopamine complement the inotropic action of digoxin and increase the rate and force of heart muscle contraction. Thesemedications can increase the risk of tachydysrhythmias. ● Quinidine increases the risk of digoxin toxicity by displacing digoxin from its binding site and reducing kidney excretion. ● Verapamil increases plasma levels of digoxin. Providers prescribe a lower dosage for clients who also take verapamil, but generally avoid concurrent use because verapamil’s cardiosuppressive action counteracts digoxin’s therapeutic effects. ● Antacids decrease the absorption of digoxin and can decrease its effectiveness. Evaluation of Medication Effectiveness ● Control of heart failure ● Absence of cardiac dysrhythmias ACTIVE LEARNING TEMPLATES Medication Administration ●Check pulse rate and rhythm before administering digoxin and document it. Notify the provider if the heart rate is less than 60/min in adults, 70/min in children, or 90/min in infants. ● Administer digoxin at the same time each day. ● Monitor digoxin levels periodically during treatment and make sure therapeutic levels are between 0.5 and 0.8 ng/mL to prevent digoxin toxicity. ● Advise clients against taking over-the-counter medications to prevent adverse effects and medication interactions. ● When caring for clients who receive IV digoxin, monitor for dysrhythmias. Nursing Interventions ● Monitor digoxin levels periodically during treatment. The expected reference range is 0.5 to 0.8 ng/mL. ● Monitor serum potassium levels because hypokalemia can cause cardiac dysrhythmias, especially in older adult clients. Monitoring the ECG to check for dysrhythmias. Client Education ●Take digoxin at the same time each day. The client should not skip a dose or take more than the dose the prescribed each day. ● Monitor for manifestations of toxicity. ● Report any new prescriptions and contact the provider before taking over-thecounter medications, because digoxin interacts with many other substances Therapeutic Procedure  A7 ...
View Full Document

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

  • Left Quote Icon

    Student Picture

Stuck? We have tutors online 24/7 who can help you get unstuck.
A+ icon
Ask Expert Tutors You can ask You can ask You can ask (will expire )
Answers in as fast as 15 minutes