Which is the common side effect of Lanoxin therapy?

Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2021

Explanation

Loss of appetite (anorexia) is one of the earliest and most common signs of Digoxin toxicity.
Gastrointestinal symptoms, including anorexia, nausea, and vomiting, often precede more severe cardiac or neurological symptoms.
It serves as a crucial warning sign for the nurse and patient to report, prompting assessment for toxicity.

Option A: This symptom (tinnitus) is a classic sign of salicylate (aspirin) toxicity, not digoxin toxicity.
Option C: Bruising or bleeding indicates a problem with blood coagulation, commonly associated with anticoagulant medications.
Option D: While visual disturbances like photophobia and seeing yellow-green halos (xanthopsia) are signs of digoxin toxicity, they typically occur after the initial gastrointestinal symptoms like loss of appetite.

Clinical Relevance

Nursing practice connection: Knowing Side effects and toxicity of Digoxin (Lanoxin) helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses must meticulously monitor patients on Digoxin for early signs of toxicity, as the therapeutic range is very narrow (0.5-2 ng/mL).
A key nursing action before administering Digoxin is to check the apical pulse for one full minute. The dose is typically held if the pulse is below 60 bpm in an adult.
Hypokalemia (low potassium) significantly increases the risk of Digoxin toxicity. Therefore, monitoring serum potassium levels is critical, especially if the patient is also on potassium-wasting diuretics.

How to Approach the Question

First, identify the drug in question: Lanoxin is the brand name for Digoxin.
The question asks for a 'common' side effect. This requires recalling the typical adverse effect profile of the medication.
Evaluate each option based on your knowledge of pharmacology.
Recall that gastrointestinal effects (like loss of appetite, nausea) are the earliest and most common signs of Digoxin toxicity.
Eliminate options associated with other drug classes: ringing in ears (aspirin) and bruising (anticoagulants).
Compare the remaining options. While sensitivity to light is a sign, loss of appetite is more common and appears earlier, making it the best answer.

Concept Tested & Keywords

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E6 Pharmacology Nursing Lilley 11e Part 2 p. 73-75

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