A nurse is caring for a 68-year-old male client in a cardiac clinic. Exhibits Click to highlight the findings that indicate the client may be experiencing digoxin toxicity. To deselect a finding, click on the finding again. The client reports some improvement in shortness of breath with exertion. The client reports feelings of fatigue. Upon auscultation, S3 heart sound noted. Lung sounds clear. Client has 1+ edema on ankles. Client reports nausea. Client reports constipation. Client reports blurred vision. Digoxin 2.2 ng/mL (0.8 to 2 ng/mL). Potassium 4.8 mEq/L (3.5 to 5 mEq/L). Heart rate 55/min. Respiratory rate 16/min. Blood pressure 110/80 mm Hg. Oxygen saturation 96% on room air.

Concerning Findings Client reports nausea → A classic early symptom of digoxin toxicity. Client reports constipation → Gastrointestinal symptoms like constipation can accompany toxicity. Client reports blurred vision → Visual disturbances, including blurred or yellow vision, are hallmark signs of digoxin toxicity2. Digoxin level: 2.2 ng/mL → This is above the therapeutic range (0.8–2.0 ng/mL), increasing the risk of toxicity. Heart rate: 55/min → Bradycardia is a common cardiac manifestation of digoxin toxicity2. ⚠️ Findings Not Indicative of Toxicity Improvement in shortness of breath → Suggests some therapeutic benefit, not toxicity. Fatigue → Nonspecific and common in heart failure; not diagnostic of digoxin toxicity alone. S3 heart sound → Associated with heart failure, not digoxin toxicity. Lung sounds clear → Normal finding. 1+ ankle edema → Mild fluid retention, typical in heart failure. Potassium: 4.8 mEq/L → Within normal range; hypokalemia would increase digoxin toxicity risk. Respiratory rate, blood pressure, oxygen saturation → All within normal limits.