The nurse is preparing to administer digoxin to an infant diagnosed with heart failure. Which assessment finding requires the nurse to withhold the medication and notify the healthcare provider?

Choice A rationale A blood pressure of 82/54 mmHg in an infant is typically considered within a normal range, especially for a neonate or young infant, and does not require withholding digoxin. Digoxin is intended to improve cardiac contractility and output, which may slightly elevate blood pressure over time. A systolic pressure below 70 mmHg in a neonate would be a greater concern. Choice B rationale A respiratory rate of 28 breaths per minute in an infant is generally considered within the normal range, which is typically 30 to 60 breaths per minute. A rate of 28 is slightly slow but does not indicate severe respiratory distress or a need to withhold the cardiac medication digoxin. This finding is likely unremarkable. Choice C rationale A temperature of 38.1 degrees Celsius (100.6 degrees Fahrenheit) indicates a low-grade fever, which may suggest an infection or inflammatory process. While this warrants further investigation and management, it is not a direct contraindication for administering the prescribed cardiac glycoside digoxin. Choice D rationale Digoxin is a cardiac glycoside that slows the heart rate and increases the force of myocardial contraction. The safe lower limit for administering digoxin to an infant is typically an apical heart rate of 90 to 110 beats per minute. An apical heart rate of 82 beats per minute is considered bradycardia for an infant and puts the patient at risk for digoxin toxicity, necessitating that the dose be withheld.