Page 1775 - Saunders Comprehensive Review For NCLEX-RN

g. Monitor the client taking a potassium-
losing diuretic or corticosteroids
closely for hypokalemia, because the
hypokalemia can cause digoxin
toxicity.
h. Note that older clients are more
sensitive to digoxin toxicity.
i. Advise the client to eat foods high in
potassium, such as fresh and dried
fruits, fruit juices, vegetables, and
potatoes.
j. Monitor the apical pulse for 1 full
minute; if the apical pulse rate is lower
than 60 beats per minute, the
medication should be withheld and the
PHCP notified.
k. Teach the client how to measure the
pulse and to notify the PHCP if the
pulse rate is lower than 60 or more
than 100 beats per minute.
l. Teach the client the signs and symptoms
of toxicity.
m. Antidote: Digoxin immune Fab is used
in extreme toxicity.
VI. Antihypertensive Medications: Diuretics (Box 53-6)
A. Thiazide diuretics (Box 53-7)
1. Description
a. Thiazide diuretics increase sodium and
water excretion by inhibiting sodium
reabsorption in the distal tubule of the
kidney.
b. Used for hypertension and peripheral
edema
c. Not effective for immediate diuresis
d. Used in clients with normal renal
function (contraindicated in clients
with renal failure)
e. Thiazide diuretics should be used with
caution in the client taking lithium,
because lithium toxicity can occur, and
in the client taking digoxin,
corticosteroids, or hypoglycemic
medications.

2. Side and adverse effects

a. Hypercalcemia, hyperglycemia,
hyperuricemia
b. Hypokalemia, hyponatremia

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