Prior to administering digoxin to a client with congestive heart failure, the nurse needs to assess:
A . Respiratory rate for 1 minute
B . Radial pulse for 1 minute
C . Radial pulse for 2 minutes
D . Apical pulse for 1 minute
Answer: D
Explanation:
(A) Respiratory rate is not directly affected by digoxin therapy.
(B) A radial pulse is not as accurate as an apical pulse. Dysrhythmias may not be detected.
(C) A radial pulse is not as accurate as an apical pulse, regardless of assessment time.
(D) Apical pulse should be measured for 1-minute prior to digoxin administration. Digoxin decreases the heart rate. Digoxin should be withheld if apical rates are <60 bpm or >120 bpm.