A nurse is providing teaching about digoxin administration to the parents of a toddler who has heart failure. Which of the following statements should the nurse include in the teaching?

Choice A reason: Limiting potassium intake is dangerous with digoxin, as low potassium (hypokalemia) increases the risk of digoxin toxicity by enhancing drug binding to cardiac cells. Adequate potassium levels are critical for safe use, as digoxin affects cardiac contractility, making this instruction incorrect and potentially harmful. Choice B reason: Repeating a digoxin dose if the child vomits within 1 hour is unsafe without medical consultation, as it risks overdose. Digoxin has a narrow therapeutic index, and toxicity can cause arrhythmias. Parents should contact the provider for guidance, making this instruction incorrect and dangerous. Choice C reason: Adding digoxin to juice risks inaccurate dosing, as the child may not consume the full amount, leading to underdosing or toxicity if additional doses are given. Precise administration (e.g., via syringe) ensures correct dosing, critical for digoxin’s narrow therapeutic range, making this instruction inappropriate. Choice D reason: Having the child drink water after digoxin ensures the dose is fully swallowed, preventing loss from spitting or incomplete ingestion. This supports accurate dosing, essential for digoxin’s safe use in heart failure, where it enhances cardiac output. This instruction is safe and effective, making it correct.