Điều dưỡng xem lại ghi chú theo dõi của một bệnh nhân đang dùng digoxin. Những phát hiện nào cần theo dõi ngay trước liều tiếp theo? Đánh dấu các phát hiện liên quan đến khả năng ngộ độc hoặc tăng nguy cơ ngộ độc.

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.