QLexNursing

🟩 This is particularly important because digoxin has a narrow therapeutic index.

🟩 Nausea is one of the most common gastrointestinal signs of digoxin toxicity.

🟩 Digoxin stimulates the chemoreceptor trigger zone, resulting in nausea, anorexia, or vomiting.

🟩 GI symptoms typically appear before cardiac conduction issues, making them useful early indicators.

🟩 The nurse should closely assess new GI disturbances in clients on digoxin.

🟩 Prompt recognition prevents worsening toxicity and prevents arrhythmias.

🟩 Even mild nausea in a digoxin user should trigger evaluation of serum digoxin levels.

Dysrhythmia

🟩 Dysrhythmias are the most dangerous adverse effect of digoxin and often occur in toxicity.

🟩 Digoxin increases intracellular calcium in cardiac tissue, altering AV node conduction and predisposing the client to ectopic beats or heart block.

🟩 Brady-arrhythmias, tachyarrhythmias, or AV dissociation can occur.

🟩 The nurse must carefully monitor apical pulse and rhythm before each dose.

🟩 New-onset irregular rhythms require immediate evaluation of potassium levels and serum digoxin levels.

🟩 Cardiac dysrhythmias are a leading cause of hospitalization in clients with digoxin toxicity.

Hyperactivity

🟩 Digoxin toxicity causes fatigue, weakness, and lethargy, not hyperactivity.

🟩 Increased CNS stimulation is not associated with this medication.

Increased appetite

🟩 Digoxin more commonly causes anorexia, especially early in toxicity progression.

🟩 Increased appetite is contradictory to expected effects.