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Digoxin hold questions test apical pulse, toxicity symptoms, potassium, renal clearance, and whether the nurse recognizes the risk before giving the dose.
Study aid - not medical advice. Not a clinical decision tool. For NCLEX pharmacology review only.
1. Count the apical pulse for 1 full minute before administration.
2. Compare the pulse with the ordered hold parameter or institutional protocol.
3. Check for nausea, vomiting, anorexia, visual halos, confusion, and new arrhythmias.
Notify the provider and follow institutional protocol for adult apical pulse <60 bpm, suspected toxicity, new dysrhythmia, visual changes, severe GI symptoms, or marked electrolyte abnormality.
Do not independently treat bradycardia or potassium changes. Anticipate ordered evaluation and correction.
Digoxin level: NCLEX commonly uses 0.5-2.0 ng/mL. Heart failure targets may be lower in current practice.
Watch K+, Mg++, BUN, creatinine, and renal function trends. Hypokalemia increases toxicity risk even when digoxin level looks therapeutic.