Question

a nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for iv calcium gluconate. the nurse should identify that which of the following medications can interact with calcium gluconate?

felodipine
guaifenesin
digoxin
regular insulin

Explanation:

Analyze the clinical scenario

The client has hypocalcemia and is prescribed IV calcium gluconate. We need to identify which medication on the client's record interacts with calcium gluconate.

Evaluate the drug interaction

Using the Calcium Gluconate and Cardiac Glycosides knowledge points

$$ \text{Hypercalcemia} + \text{Digoxin} \implies \text{Increased risk of Digoxin toxicity and severe arrhythmias} $$

Using the Digoxin Toxicity knowledge point

• Calcium ions increase cardiac contractility and can potentiate the effects of digoxin on the myocardium.
• Administering IV calcium to a patient taking digoxin can precipitate serious, potentially fatal cardiac arrhythmias.

Assess other options

• Felodipine: A calcium channel blocker. While it affects calcium channels, it does not have a major, dangerous interaction with IV calcium gluconate in this clinical context.
• Guaifenesin: An expectorant with no interaction with calcium gluconate.
• Regular insulin: Used to treat hyperglycemia or hyperkalemia; does not have a direct dangerous interaction with calcium gluconate.

Answer:

• Felodipine
• Guaifenesin
• Digoxin (Correct answer)
• Regular insulin