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NURS 1556 Clinical Medications Worksheets

(You will need to make additional copies of these forms)

Generic Name Trade Name Classification Dose Route Time/frequency

Digoxin Lanoxin Antiarrhythmics 0.125 mg PO Every day

Peak Onset Duration For IV meds, compatibility with IV drips and /or solutions
2 to 8 hours 30 to 120 minutes 2 to 4 days N/A

Mechanism of action and indications Nursing Implications (what to focus on)

(Why med ordered) Contraindications/warnings/interactions
Treatment of CHF. Tachyarrhythmias: Atrial fibrillation and atrial Hypersensitivity, Uncontrolled ventricular arrhythmias; AV block;
flutter, paroxysmal atrial tachycardia. idiopathic hypertrophic subaortic stenosis; constrictive pericarditis;
known alcohol intolerance. Thiazide and loop diuretics and
Increases force of myocardial contraction. Prolongs refractory period corticosteroids. Geri patients=increased risk of toxicity, MI, Renal
of the AV node. Decreases conduction through the SA and AV impairment, and obesity.
nodes. Increased cardiac output and slowing of the heart rate. Common side effects
Headache, weakness, blurred vision, yellow or green vision, arrhythmias,
Ordered for: Atrial Fibrillation bradycardia, ECG changes, AV block, SA block, anorexia, nausea,
vomiting, diarrhea, thrombocytopenia, electrolyte imbalances with acute
digoxin toxicity.

Interactions with other patient drugs, OTC or herbal Lab value alterations caused by medicine
medicines (ask patient specifically) Evaluate serum electrolyte levels, especially potassium, magnesium, and
Thiazide and loop diuretics and corticosteroids and excessive use of calcium and renal and hepatic functions periodically during therapy.
laxatives- milk of magnesia, bisacodyl suppository, and Senna-s Notify primary care provider before giving a dose to a hypokalemic
Also, high fiber meals may alter absorption of digoxin. patient. Geriatric patients may be toxic even if in normal range—assess
for signs of toxicity.
Be sure to teach the patient the following about this
Take at same time each day as directed. Take missed doses within 12
hours of scheduled dose or not taken at all. Don’t double doses. Teach
patient to take pulse and contact health care professional before taking
medication if pulse is less than 60 or greater that 100. Review fall
prevention strategies. EMPHASIZE follow- up exams.
Nursing Process- Assessment Assessment Evaluation
(Pre-administration assessment) Why would you hold or not give this Check after giving
med? Check apical pulse, edema, blood
Apical pulse rate, vital signs. Intake and output, daily Pulse less than 60 or greater than 100 pressure
weight, peripheral edema, auscultate lungs for Allergy
rales/crackles, find out patient digitalis history of last 2
to 3 weeks, and assess fall risk.