Question

a nurse is providing teaching to a client who is to start therapy with digoxin. for which of the following adverse effects should the nurse instruct the client to monitor and report to the provider?

dry cough
pedal edema
bruising
yellow-tinged vision

Explanation:

Identify the drug and its mechanism

The question asks about the adverse effects of digoxin, a cardiac glycoside used to treat heart failure and atrial fibrillation. It works by inhibiting the sodium-potassium ATPase pump, which increases intracellular calcium and enhances cardiac contractility.

Analyze clinical manifestations of toxicity

Digoxin has a narrow therapeutic index, making toxicity a significant clinical concern. Early signs of digoxin toxicity include gastrointestinal symptoms (anorexia, nausea, vomiting) and neurological/visual disturbances.

Evaluate the visual adverse effects

A classic and specific sign of digoxin toxicity is visual changes, particularly xanthopsia, which manifests as yellow-green or yellow-tinged vision, halos around lights, or blurred vision.

Differentiate from other options

• Dry cough is a classic adverse effect of ACE inhibitors, not digoxin.
• Pedal edema is a sign of worsening heart failure, which digoxin is used to treat, rather than a direct adverse effect of the drug itself.
• Bruising is associated with anticoagulants or antiplatelet therapies, not digoxin.

Answer:

• Dry cough
• Pedal edema
• Bruising
• Yellow-tinged vision (Correct answer)