The nurse should instruct a patient who is to receive digoxin (Lanoxin) to report development of which of the following side effects?

Appeared in: GMCH Chandigarh - 2019

Explanation

The correct option is 'Sensitivity to sunlight, double vision' because visual disturbances are a hallmark sign of digoxin toxicity.
Digoxin toxicity can manifest as a variety of visual changes, including diplopia (double vision), photophobia (sensitivity to light), blurred vision, and xanthopsia (seeing yellow-green halos or colors).
Patients must be educated to report any new or worsening visual symptoms to their healthcare provider immediately, as this may indicate a need to adjust the dose or check serum digoxin levels.

Option A: Ringing in the ears (tinnitus) is a symptom of ototoxicity, not a characteristic sign of digoxin toxicity.
Option B: Alopecia (hair loss) is not a known or common side effect associated with digoxin therapy.
Option C: Signs of bruising (ecchymosis) suggest a problem with blood clotting or platelet function.

Clinical Relevance

Nursing practice connection: Use the key finding related to Patient education regarding signs of digoxin toxicity to guide bedside assessment, documentation, and the next nursing action.
A key nursing responsibility before administering digoxin is to check the apical pulse for one full minute. The dose is typically held and the provider notified if the heart rate is less than 60 bpm for an adult.
Nurses must monitor serum potassium levels. Hypokalemia (low potassium) significantly increases the risk of digoxin toxicity, as potassium and digoxin compete for the same binding sites on the Na+/K+ ATPase pump.
What if? If a patient on digoxin and a loop diuretic (which wastes potassium) reports nausea and seeing yellow halos, the nurse's priority is to assess vital signs, hold the next digoxin dose, and notify the provider to request orders for serum digoxin and potassium levels.

How to Approach the Question

First, identify the drug in the question: Digoxin (Lanoxin).
Recall the drug's class (cardiac glycoside) and its primary use (heart failure, atrial fibrillation).
Recognize that questions about reportable side effects often focus on signs of toxicity, especially for drugs with a narrow therapeutic index like digoxin.
Evaluate each option based on the known side effect profile of digoxin. Ask yourself, 'Is this a classic sign of digoxin toxicity?'
Eliminate options that are characteristic side effects of other common drug classes (e.g., tinnitus for ototoxic drugs, bruising for anticoagulants).
Select the option that represents a well-documented sign of digoxin toxicity, which in this case is visual disturbances.

Concept Tested & Keywords

QGwvgqsuuo2J-btd2WaWlD

E6 Pharmacology Nursing Lilley 11e Part 2 pp. 73-75, 76-78, 78-80

Practise the full GMCH Chandigarh - 2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.