A nurse is teaching the parent of a preschool-age child about digoxin administration. Which of the following statements by the parent indicates an understanding of the teaching?

Digoxin administration in pediatrics requires strict safety protocols to prevent toxicity and dental damage. The nurse must apply knowledge of medication safety, pediatric dosing, and pharmacological side effects, specifically the high glucose content often found in pediatric liquid preparations of digoxin. Choice A rationale . Pediatric digoxin elixirs often contain high concentrations of sugar to mask the bitter taste. Regular brushing after administration prevents dental caries and maintains oral hygiene. This action demonstrates the parent understands how to mitigate the long-term side effects. Choice B rationale . Mixing medication with large volumes of liquid like orange juice is discouraged. If the child does not finish the entire four ounces, the nurse cannot determine the exact dose received. Medication should be given directly via the oral syringe provided. Choice C rationale . Vomiting is a classic sign of digoxin toxicity in children. Repeating the dose could dangerously increase the heart rate suppression and lead to lethal arrhythmias. The parent must notify the provider immediately rather than re-administering the medication. Choice D rationale . The apical pulse must be taken for a full 60 seconds, not 30, to ensure accuracy in detecting bradycardia. For a preschooler, the medication is typically withheld if the heart rate is less than 90 beats per minute.