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b, c, e
Rationale
Maintenance doses of digoxin (Lanoxin) are given every 12 hours, such as at 8 AM and 8 PM. Digoxin can be dangerous, because it has a narrow margin of safety of therapeutic, toxic, and lethal doses. Frequent vomiting, poor feeding, or a slow heart rate can be signs of toxicity. The health care provider must be notified if any of these signs are observed in the child. The child must be given water after administering
the drug and encouraged to brush the teeth to prevent tooth decay. The drug must not be mixed with food or fluids, because the child will receive an inaccurate dosage if the child refuses to have the food and other fluids. If the child vomits after a dose, a second dose should not be given, because this may lead to an overdose.
a, c, d
Rationale
While providing care to a patient who is prescribed nitroglycerin, the nurse should monitor for the use of
sildenafil, assess blood pressure at regular intervals, and ask the patient to lie down with the head of the bed at a comfortable level. Sildenafil, when administered with nitroglycerin, can cause a drastic drop in blood pressure; therefore, the nurse should avoid administering these drugs together. Blood pressure is monitored at regular intervals because nitroglycerin causes vasodilation, which can cause hypotension. Instructing the patient to lie down with the head of the bed at a comfortable
level will reduce the risk of hypotension. Nitroglycerin does not need to be taken with food. Cough, shortness of breath, edema, and weight gain are associated with beta blockers, not nitrates.
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