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Digoxin Concept Map

Concept map that diagrams the various pharmacological properties and important facts of the medication, digoxin

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Emily Chiaravalloti
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635 views1 page

Digoxin Concept Map

Concept map that diagrams the various pharmacological properties and important facts of the medication, digoxin

Uploaded by

Emily Chiaravalloti
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Digoxin could potentially worsen AV block

or ventricular dysrhythmias that are


unrelated to heart failure. Geriatric and
pediatric patients should be monitored
closely because they may have inadequate
renal clearance and/or metabolizing
hepatic enzymes. Additionally, caution
should be taken when using this drug in
e
patients with a myocardial infarction,
x or cor pulmonale
hypothyroidism,

e
x digoxin level results before
Check serum

administration; digoxin would be held and


a physician would be contacted if the level
is higher than the set parameter (usually
1.8 ng/mL). Also, evaluate electrolyte
levels because hypokalemia,
hypomagnesemia, or hypercalcemia
create greater susceptibility to toxicity.

Digoxin has its onset within 30-60 minutes when


taken orally and peaks at 4-6 hours; its onset is
within 5-30 minutes when administered
intravenously and peaks at 1.5 hours. It results in
increased cardiac output and slowing of the heart
rate by increasing the force of myocardial
contraction, prolonging refraction in the AV node,
and decreases conduction in the SA and AV
nodes

T
e
xt

Digoxin overdose could be fatal and the antidote is


an IV infusion of Digibind, providing antibodies for
digoxin. All dosing of digoxin is determined on
individual bases, but is often given in several
larger loading doses over 12-24 hours for a rapid
effect. The maintenance doses are then
determined by individual renal function

Digoxin
Take apical pulse for a full minute
(rate, rhythm, and quality) before
administration and notify physician if
the rate is lower than the set
parameter (60 bpm)

Important to take the medicine at the same time every day. If a dose is missed, either
take it within 12 hours, or simply omit that dose. The patient should not discontinue
the medication without consulting a physician. The nurse should teach how to take a
pulse, and contact a physician before taking digoxin if the resting heart rate was lower
than 60 (bradycardia) or higher than 100 (tachycardia). The skill of taking a pulse,
particularly an apical pulse, is especially important in pediatric patients. The patient
should not share this medication or mix it with other pills in a container separate from
the original prescription bottle. Symptoms of digoxin toxicity can often be mistaken for
a cold or the flu, so side effects should be monitored carefully. A contact method
should be put in place to notify a physician if those symptoms or the symptoms of
heart failure occur as a result. The patient should carry identification describing their
disease and medication at all times. Additionally, they should avoid taking antacids or
antidiarrheals within two hours of taking digoxin.

e
x

The most dangerous effect is dysrhythmias, especially in


hypokalemic or renal impaired patients. Other side effects
include nausea, vomiting, fatigue, anorexia, and visual
disturbances. Digoxin and diuretics could cause
hypokalemia. Digoxin and ACE inhibitors could cause
hyperkalemia. Use with antacids or cholesterol-loweringdrugs decreases the absorption of digoxin. Intravenous
calcium can increase the risk for dysrhythmias. Digoxin
toxicity risk is increased when combined with several
different types of medications, as well as potentially the
herb, ginseng.

ND: Decreased cardiac output; deficient knowledge related to


medication (treated with patient/family teaching)
Outcomes: Can help decrease severity of heart failure, increase
cardiac output, decrease ventricular response in atrial
tachyarrhythmias and terminate paroxysmal atrial tachycardia
Implications: Digoxin is used for heart failure, atrial fibrillation/atrial
flutter, and paroxysmal atrial tachycardia
Interventions: Oral preparations of digoxin should be given
consistently regarding meals. Intramuscular administration should
be given into a deep gluteal muscle and then massaged well,
although this intervention is usually not recommended. If given
intravenously, it may be administered without dilution and should be
administered over at least 5 minutes. Diluted digoxin must be
prepared as 1 mL per 4 mL of sterile water, D5W, or 9% NaCl to
avoid precipitation.

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