Digoxin on the NCLEX
Digoxin: therapeutic level, apical pulse, hypokalemia + digoxin = toxicity, antidote DigiFab.
Digoxin is a cardiac glycoside used for HF and AFib rate control. Narrow window. NCLEX favorite.
Therapeutic level
0.5-2.0 ng/mL. Toxicity above 2.
Hold parameters
Check apical pulse 1 full minute. Hold for HR <60 (adult), <70 (child), <100 (infant).
Toxicity signs
N/V, anorexia, yellow-green halos, blurred vision. Bradycardia, arrhythmias. Hypokalemia worsens toxicity (loop/thiazide diuretics).
Antidote
Digoxin immune Fab (DigiFab). Severe toxicity or unstable.
Teaching
Take same time daily. Pulse before dose. Don't double up missed doses.
Frequently asked
Why hypokalemia worsens dig toxicity?
Digoxin competes with K+ at the Na/K-ATPase. Low K+ → more digoxin effect.
Patient on Lasix and digoxin?
Monitor K+ carefully. Replace K+ as needed. High-risk combination.
Quick check
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