Client Presentation:
•Fatigue, drowsy, headache, dizziness, confusion, hallucinations (CNS)
•Visual disturbances: Yellow-green distortion is most common, but red, brown, blue, and white also have been reported
•Anorexia, N/V/D, weight loss, and abdominal pain
•Manifestations of CHF exacerbation: BLE edema, SOA, palpitations, hypotension, and bradycardia
Treatment focuses mainly on monitoring cardiac function and correcting dysrhythmias/arrhythmias by the balancing of electrolytes in the body (K+, Na, Ca etc...)
Obviously, prevention is the key. Keeping medication out of the hands of children, as well as performing the five rights with every administration is critical to ensure accidental ingestion and toxicity do not occur.
Monitoring of other medications administered in conjunction with Digoxin is critical as well. Some antibiotics can increase the serum levels.
So all medications should be reviewed. Loop diuretics especially can alter the serum levels.
Education provided to patients regarding polypharmacy and staying with one pharmacy is crucial to reduce the incidence of drug on drug interaction.
Veronica Cheney, RN,BSNS
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