The nurse reviews a follow-up note for a client taking digoxin. Which findings require immediate follow-up before the next dose? Highlight the findings associated with possible toxicity or increased toxicity risk.

Nurses' Notes 0830: The home-care nurse completes a medication follow-up. The client states that digoxin is taken at the prescribed time each morning. The client denies missing or doubling a dose. At rest, the apical pulse is regular at 72/min. During breakfast, the client reports new nausea and yellow halos around the kitchen lights. The current weight is unchanged from last week's measurement. Today's laboratory report shows a potassium level of 4.2 mEq/L. At 0900, reassessment shows an apical pulse of 46/min with new dizziness on standing. A digoxin level was collected eight hours after yesterday's dose. The record confirms that the blood sample was timed eight hours after the dose. Last month's creatinine was 0.9 mg/dL. Today, creatinine is 1.8 mg/dL and potassium is 3.0 mEq/L. The medication list has not otherwise changed. The client reports that the daily weight remains within 0.5 kg of baseline. The nurse observes that the client uses a dated pill organizer for all scheduled doses. The next digoxin dose has not been taken.