The nurse is caring for an adult client who is taking digoxin. Which laboratory value should be reported to the healthcare provider immediately?Reference Range:• Sodium: 136 to 145 mEq/L (136 to 145 mmol/L)• Digoxin level: 0.8 to 2.6 ng/mL (0.6 to 13 nmol/L)• Potassium (K+): 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)• Creatinine: 0.5 to 1.1 mg/dL (44 to 97 µmol/L)
Explanation & Rationale
Choice A Reason:A digoxin level of 1.1 ng/mL is within the therapeutic range of 0.8 to 2.6 ng/mL. Therefore, this value does not require immediate reporting to the healthcare provider. Monitoring digoxin levels is important to avoid toxicity, but this specific level is considered safe.Choice B Reason:A potassium level of 3.2 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia (low potassium levels) can increase the risk of digoxin toxicity, as digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump. Low potassium levels can enhance the effects of digoxin, leading to potentially dangerous cardiac arrhythmias. Therefore, this value should be reported immediately.Choice C Reason:A creatinine level of 0.8 mg/dL is within the normal range of 0.5 to 1.1 mg/dL. This value indicates normal kidney function, which is important for the excretion of digoxin. Therefore, this value does not require immediate reporting.Choice D Reason:A sodium level of 135 mEq/L is just below the normal range of 136 to 145 mEq/L. While slightly low, this value is not critically abnormal and does not pose an immediate threat. It should be monitored, but it does not require urgent reporting to the healthcare provider.