The nurse assesses a client before administering digoxin. What finding would cause the nurse to withhold the drug and notify the primary health care provider?

A. Respiratory rate of 13 breaths/min: A respiratory rate of 13 breaths per minute is within the normal range for adults (12-20 breaths per minute). This finding does not indicate a need to withhold digoxin, which primarily affects heart rate and rhythm. B. History revealing liver failure: Although liver failure can impact drug metabolism, digoxin is primarily excreted by the kidneys, so liver failure is not an immediate concern in this case, withholding it for liver failure alone is not required. C. Pulse 44 beats/min: A pulse rate of 44 beats per minute is bradycardia, which is a significant concern when administering digoxin. Digoxin can further slow the heart rate, withholding the drug is necessary to prevent potential complications such as heart block or arrhythmias. D. Blood pressure 102/66 mmHg: A blood pressure of 102/66 mmHg is within an acceptable range and does not indicate an immediate need to withhold digoxin. The focus for withholding the drug would be on the heart rate or rhythm, not blood pressure in this context.