PN Adult Medical Surgical Practice Exam

What should the nurse do if a client's apical pulse is 58/min and has a digoxin order?

1. Give the dose as prescribed.

2. Use a different route to administer the medication.

3. Administer half of the prescribed dose.

4. Withhold the dose.

The correct answer is: Withhold the dose.

The recommended action when a client’s apical pulse is 58 beats per minute and they have an order for digoxin is to withhold the dose. Digoxin is a cardiac glycoside used primarily to treat heart conditions such as atrial fibrillation and heart failure. It works by increasing the force of heart contractions and slowing down the heart rate. In assessing the apical pulse, a rate below 60 beats per minute may indicate bradycardia, which can be a concerning side effect in patients taking digoxin. Withholding the medication is critical because administering digoxin when the heart rate is significantly low can lead to further bradycardia or potential cardiac complications, including the risk of digoxin toxicity. The nurse should also consider further evaluation and monitoring of the client's condition, potentially consulting with the healthcare provider for further instructions. The other options are less appropriate or safe in the context of this scenario.