Digoxin (Lanoxin) Nursing Considerations

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Kara Tarr
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Outline

Generic Name

Digoxin

Trade Name

Lanoxin

Indication

CHF, AFib, A-flutter

Action

Positive inotropic effect (increases force of myocardial contraction), prolongs
refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is
given to increase cardiac output and slow the rate.

Therapeutic Class

Antiarrhythmic, inotropics

Pharmacologic Class

Digitalis glycosides

Nursing Considerations

• Excreted by kidneys
• Assess patient for hypersensitivity
• Contraindicated with uncontrolled ventricular arrhythmias
• Hypokalemia increase risk for toxicity
• Hypercalcemia ↑ risk for toxicity
• Use caution with diuretic use as they may cause electrolyte abnormalities
that can lead to toxicity
• Assess patient for cardiac arrhythmias including bradycardia
• Signs of toxicity include vision changes (blurred vision, yellow, green vision
disturbances)
• Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse <60)

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Transcript

Hey guys, let’s talk about, Digoxin also known as Lanoxin. This is an oral and injectable medication, as you can see here in the picture. So remember when we talk about the therapeutic class, we are talking about how the drug works in the body while the pharmacologic class is the chemical effect of the drug. So for digoxin, the therapeutic class is an antiarrhythmic and an inotropic while the pharmacologic class is a digitalis glycoside. So what is the mechanism of action of Digoxin? So digoxin has a positive inotropic effect, which means it increases the force of myocardial contraction and the refractory period is prolonged. Digoxin decreases conduction through the SA and AV nodes, which is how digoxin helps with AFib in AF flutter and is given to increase the cardiac output and slow rate. So like I just mentioned, digoxin is indicated for atrial fibrillation, atrial flutter, and also congestive heart failure.
So with digoxin, we can see some side effects including dizziness, fainting, bradycardia because remember it slows the rate and even in a regular heartbeat. So let’s take a look at a few nursing considerations for digoxin; assess your patient for hypersensitivity, cardiac arrhythmias, and bradycardia before administering. check your patient’s pulse for one full minute prior to giving them the medication and guys hold for a pulse that is less than 60. Guys, that information is super important to remember, and you will definitely see it again sometime in your future, I am sure of it. So digoxin is contraindicated for patients who have uncontrolled ventricular arrhythmias; issues like hypokalemia, hypercalcemia, and even diuretics because of the electrolyte abnormal abnormalities that can result all increase the risk of toxicity. Be sure to teach your patients signs of toxicity, which include blurred vision and yellow and green vision disturbances. So guys, when we think of digoxin, think that we give this medication to patients who have a weak heart as that helps the heart to squeeze. That’s it for digoxin or Lanoxin. Now go out and be your best self today. And as always happy nursing.

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6 week

Concepts Covered:

  • Gastrointestinal Disorders
  • Respiratory Disorders
  • EENT Disorders
  • Infectious Disease Disorders
  • Lower GI Disorders
  • Integumentary Disorders
  • Neurologic and Cognitive Disorders
  • Medication Administration
  • Hematologic Disorders
  • Integumentary Disorders
  • Cardiovascular Disorders
  • Musculoskeletal Disorders
  • Endocrine and Metabolic Disorders
  • Renal and Urinary Disorders
  • Urinary System
  • Studying
  • Oncologic Disorders
  • Central Nervous System Disorders – Brain
  • Renal Disorders
  • Infectious Respiratory Disorder
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Sexually Transmitted Infections
  • EENT Disorders

Study Plan Lessons

Abdomen (Abdominal) Assessment
ABG (Arterial Blood Gas) Interpretation-The Basics
ABG (Arterial Blood Gas) Oxygenation
ABGs Nursing Normal Lab Values
ABGs Tic-Tac-Toe interpretation Method
Acetaminophen (Tylenol) Nursing Considerations
Acute Bronchitis
Acute Otitis Media (AOM)
Airborne Precaution Diseases Nursing Mnemonic (MTV)
Albuterol (Ventolin) Nursing Considerations
Alveoli & Atelectasis
Amoxicillin (Amoxil) Nursing Considerations
Anti-Infective – Antivirals
Anti-Infective – Macrolides
Anti-Infective – Penicillins and Cephalosporins
Anti-Infective – Fluoroquinolones
Appendicitis
Appendicitis – Assessment Nursing Mnemonic (PAINS)
Appendicitis Case Study (Peds) (30 min)
Appendicitis for Certified Emergency Nursing (CEN)
Assessment of a Burn Nursing Mnemonic (SCALD)
Asthma
Asthma Concept Map
Asthma management Nursing Mnemonic (ASTHMA)
Attention Deficit Hyperactivity Disorder (ADHD)
Autism Spectrum Disorders
Base Excess & Deficit
Bisacodyl (Dulcolax) Nursing Considerations
Blood Brain Barrier (BBB)
Blood Type O Nursing Mnemonic (Universally Odd)
Bronchiolitis and Respiratory Syncytial Virus (RSV)
Bronchodilators
Bupropion (Wellbutrin) Nursing Considerations
Burn Injuries
Burn Injury Case Study (60 min)
Burns for Certified Emergency Nursing (CEN)
Cardiac Glycosides
Care of the Pediatric Patient
Casting & Splinting
Cefaclor (Ceclor) Nursing Considerations
Celiac Disease
Cerebral Palsy (CP)
Cimetidine (Tagamet) Nursing Considerations
Ciprofloxacin (Cipro) Nursing Considerations
Cleft Lip and Palate
Cleft Lip Repair – Post Op Care Nursing Mnemonic (CLEFT LIP)
Clubfoot
Congenital Heart Defects (CHD)
Conjunctivitis
Constipation and Encopresis (Incontinence)
Corticosteroids
Coumarins
Cyanotic Defects Nursing Mnemonic (The 4 T’s)
Cystic Fibrosis (CF)
Day in the Life of a NICU Nurse
Day in the Life of a Peds (Pediatric) Nurse
Defects of Decreased Pulmonary Blood Flow
Defects of Increased Pulmonary Blood Flow
Dehydration
Diarrhea – Treatment Nursing Mnemonic (BRAT)
Digoxin (Lanoxin) Nursing Considerations
Diphenhydramine (Benadryl) Nursing Considerations
Diphenoxylate-Atropine (Lomotil) Nursing Considerations
Eczema
EENT Assessment
Enuresis
Epiglottitis
Epiglottitis – Signs and Symptoms Nursing Mnemonic (AIR RAID)
Epispadias and Hypospadias
Famotidine (Pepcid) Nursing Considerations
Fever
Fever Case Study (Pediatric) (30 min)
Flu Symptoms Nursing Mnemonic (FACTS)
Fluid Compartments
Fluid Pressures
Fluid Shifts (Ascites) (Pleural Effusion)
Fluid Volume Deficit
Fluticasone (Flonase) Nursing Considerations
Gas Exchange
Gentamicin (Garamycin) Nursing Considerations
Glucose Lab Values
Gluten Free Diet Nursing Mnemonic (BROW)
Guaifenesin (Mucinex) Nursing Considerations
Heart Sounds Nursing Mnemonic (APE To Man – All People Enjoy Time Magazine)
Hematocrit (Hct) Lab Values
Hemoglobin (Hbg) Lab Values
Hemophilia
Hierarchy of O2 Delivery
Hydrocephalus
Hypoxia – Signs and Symptoms (in Pediatrics) Nursing Mnemonic (FINES)
Ibuprofen (Motrin) Nursing Considerations
Immunizations (Vaccinations)
Imperforate Anus
Impetigo
Indomethacin (Indocin) Nursing Considerations
Influenza – Flu
Integumentary (Skin) Assessment
Intussusception
Intussusception for Certified Emergency Nursing (CEN)
Iron Deficiency Anemia
Isolation Precaution Types (PPE)
Isolation Precautions (MRSA, C. Difficile, Meningitis, Pertussis, Tuberculosis, Neutropenia)
Lactulose (Generlac) Nursing Considerations
Leukemia
Levels of Consciousness (LOC)
Levetiracetam (Keppra) Nursing Considerations
Lung Sounds
Marfan Syndrome
Meningitis
Meningitis Assessment Findings Nursing Mnemonic (FAN LIPS)
Meningitis for Certified Emergency Nursing (CEN)
Methylphenidate (Concerta) Nursing Considerations
Mixed (Cardiac) Heart Defects
Mumps
Nephroblastoma
Nephrotic Syndrome
Nephrotic Syndrome Case Study (Peds) (45 min)
Neuro Assessment
NSAIDs
Nursing Care Plan (NCP) for Acute Bronchitis
Nursing Care Plan (NCP) for Appendicitis
Nursing Care Plan (NCP) for Asthma
Nursing Care Plan (NCP) for Asthma / Childhood Asthma
Nursing Care Plan (NCP) for Attention Deficit Hyperactivity Disorder (ADHD)
Nursing Care Plan (NCP) for Bronchiolitis / Respiratory Syncytial Virus (RSV)
Nursing Care Plan (NCP) for Burn Injury (First, Second, Third degree)
Nursing Care Plan (NCP) for Celiac Disease
Nursing Care Plan (NCP) for Cerebral Palsy (CP)
Nursing Care Plan (NCP) for Cleft Lip / Cleft Palate
Nursing Care Plan (NCP) for Clubfoot
Nursing Care Plan (NCP) for Congenital Heart Defects
Nursing Care Plan (NCP) for Constipation / Encopresis
Nursing Care Plan (NCP) for Cystic Fibrosis
Nursing Care Plan (NCP) for Decreased Cardiac Output
Nursing Care Plan (NCP) for Dehydration & Fever
Nursing Care Plan (NCP) for Eczema (Infantile or Childhood) / Atopic Dermatitis
Nursing Care Plan (NCP) for Enuresis / Bedwetting
Nursing Care Plan (NCP) for Epiglottitis
Nursing Care Plan (NCP) for Fluid Volume Deficit
Nursing Care Plan (NCP) for Hemophilia
Nursing Care Plan (NCP) for Hydrocephalus
Nursing Care Plan (NCP) for Impaired Gas Exchange
Nursing Care Plan (NCP) for Imperforate Anus
Nursing Care Plan (NCP) for Impetigo
Nursing Care Plan (NCP) for Infective Conjunctivitis / Pink Eye
Nursing Care Plan (NCP) for Influenza
Nursing Care Plan (NCP) for Intussusception
Nursing Care Plan (NCP) for Marfan Syndrome
Nursing Care Plan (NCP) for Meningitis
Nursing Care Plan (NCP) for Mumps
Nursing Care Plan (NCP) for Neural Tube Defect, Spina Bifida
Nursing Care Plan (NCP) for Omphalocele
Nursing Care Plan (NCP) for Otitis Media / Acute Otitis Media (AOM)
Nursing Care Plan (NCP) for Pediculosis Capitis / Head Lice
Nursing Care Plan (NCP) for Pertussis / Whooping Cough
Nursing Care Plan (NCP) for Phenylketonuria (PKU)
Nursing Care Plan (NCP) for Reye’s Syndrome
Nursing Care Plan (NCP) for Rheumatic Fever
Nursing Care Plan (NCP) for Rubeola – Measles
Nursing Care Plan (NCP) for Scoliosis
Nursing Care Plan (NCP) for Sickle Cell Anemia
Nursing Care Plan (NCP) for Tonsillitis
Nursing Care Plan (NCP) for Varicella / Chickenpox
Nursing Care Plan (NCP) for Vomiting / Diarrhea
Nursing Care Plan for (NCP) Autism Spectrum Disorder
Nursing Case Study for Pediatric Asthma
Obstructive Heart (Cardiac) Defects
Ocular Infections (Conjunctivitis, Iritis) for Certified Emergency Nursing (CEN)
Omphalocele
Opioid Analgesics
Pancrelipase (Pancreaze) Nursing Considerations
Pediatric Bronchiolitis Labs
Pediatric Gastrointestinal Dysfunction – Diarrhea
Pediatric Oncology Basics
Pediatrics Course Introduction
Pediculosis Capitis
Pertussis – Whooping Cough
Phenylketonuria
Phenytoin (Dilantin) Nursing Considerations
Platelets (PLT) Lab Values
Pneumonia
Promotion and Evaluation of Normal Elimination Nursing Mnemonic (POOPER SCOOP)
Pulmonary Function Test
Red Blood Cell (RBC) Lab Values
Respiratory Acidosis (interpretation and nursing interventions)
Reye’s Syndrome
Reyes Syndrome Case Study (Peds) (45 min)
Rheumatic Fever
ROME – ABG (Arterial Blood Gas) Interpretation
Rubeola – Measles
Salmeterol (Serevent) Nursing Considerations
Scoliosis
Selegiline (Eldepyrl) Nursing Considerations
Sickle Cell Anemia
Spina Bifida – Neural Tube Defect (NTD)
Steroids – Side Effects Nursing Mnemonic (6 S’s)
Stoma Care (Colostomy bag)
Strabismus
Sudden Infant Death Syndrome (SIDS)
Sympathomimetics (Alpha (Clonodine) & Beta (Albuterol) Agonists)
Thorax and Lungs Assessment
Tonsillitis
Topical Medications
Tracheal Esophageal Fistula – Sign and Symptoms Nursing Mnemonic (The 3 C’s)
Transient Incontinence – Common Causes Nursing Mnemonic (P-DIAPERS)
Treatment of Sickle Cell Nursing Mnemonic (HOP to the hospital)
Umbilical Hernia
Vaccine-Preventable Diseases (Measles, Mumps, Pertussis, Chicken Pox, Diphtheria) for Certified Emergency Nursing (CEN)
Varicella – Chickenpox
Varicella Case Study (Peds) (30 min)
Vitals (VS) and Assessment
Vomiting
White Blood Cell (WBC) Lab Values
X-Ray (Xray)