A nurse is assessing a school-age child prior to administering digoxin. For which of the following findings should the nurse withhold the medication?

A. Urine output 25 mL/hr: This output is adequate for a school-age child and does not contraindicate the administration of digoxin. Digoxin does not require withholding based on urine output unless there are signs of renal impairment. B. Respiratory rate 18/min: A respiratory rate of 18/min is within normal limits for a school-age child (approximately 18–30/min). This finding would not require withholding digoxin. C. Oxygen saturation 88%: While this value is low and requires assessment and intervention, it is not a direct contraindication for digoxin administration. The low oxygen level may be due to another cause and should be addressed separately. D. Heart rate 64/min: Digoxin slows the heart rate, and a heart rate below 70/min in a school-age child is considered bradycardic. Digoxin should be withheld in the presence of bradycardia due to the risk of further depressing the cardiac rate and leading to complications such as heart block.