NCLEX 준비 - digoxin

안녕하세요 예비 미국 간호사 선생님들
이번에는 digoxin 에 대해 공부해봅시다.
이 문제는 보통 passing level입니다.

 

** What is this?

- Inotropy: Increase Heart contraction

- Chronotropy: Decrease HR

 

** When do you use ?

- HF

- Afib/Aflutter

 

Rule #1 Digoxin = Decrease HR & K+

- Do NOT give Dgoxin to low HR or bradycardia

- Do NOT give Dgoxin to low K+ lab result

- Be ware of K+ level when pt is on loop diuretic meds

 

Rule #2 Therapeutic level

- Therapeutic: 0.5-2

Rule #3 Degoxin Toxicity

- Anorexia

- GI problem: Nausea/Vomitting

- Vision change: scotomas, blindness, color vision alternation

- Nuerologic change: confusion, lethargy, fatigue, weekness

 

 

Rule #4 Nursing Care

- Report vision change immediately to MD

- Measure pulse rate before taking meds

- Diet: Fluid and Na+ restriction

- Check Kidney (renal) and Liver function

• BUN/Cr level

- Check K+ level

- Check EKG/ECG

- Hold meds when pulre rate:

• <60 bpm for Adult
• <70 bpm for Child
• <90 bpm for Infant

- Avoid St.John's wort

- Aovid Antiacid or Laxis

 

 

* Atidote: Digoxin-specific antibody (Fab) fagment