Question

a nurse should plan to monitor a client who is receiving digoxin (lanoxin) for signs of toxicity, which include

urinary frequency.
visual disturbances.
tachycardia.
hyperthermia.

Explanation:

🆕 New Concept Discovered: Digoxin Toxicity Monitoring
Recognizing adverse effects of narrow therapeutic index drugs

Step 1: Understand the drug and its therapeutic index

Digoxin (Lanoxin) is a cardiac glycoside used to treat heart failure and certain cardiac arrhythmias (like atrial fibrillation). It has a very narrow therapeutic index, meaning the difference between a safe, effective dose and a toxic dose is very small. Because of this, monitoring for signs of digoxin toxicity is a critical nursing responsibility.

Step 2: Identify classic signs of digoxin toxicity

Digoxin toxicity affects multiple body systems. The most common and classic signs include:

• Gastrointestinal symptoms: Anorexia (loss of appetite), nausea, vomiting, and abdominal pain (usually the earliest signs).
• Neurological and Visual disturbances: Fatigue, headache, confusion, and classic visual changes such as blurred vision, double vision (diplopia), and seeing yellow-green halos around objects.
• Cardiac dysrhythmias: Most commonly bradycardia (slow heart rate) rather than tachycardia, as digoxin slows down conduction through the AV node.

Step 3: Evaluate the given options

• Urinary frequency: Not a recognized sign of digoxin toxicity.
• Visual disturbances: Correct. Visual changes (especially yellow-green halos or blurred vision) are classic, well-documented signs of digoxin toxicity.
• Tachycardia: Incorrect. Digoxin toxicity typically causes bradycardia (slow heart rate) due to its vagal effect and slowing of AV node conduction.
• Hyperthermia: Incorrect. Digoxin toxicity does not cause an elevated body temperature.

Answer:

visual disturbances.