Digoxin nursing pharmacology (NCLEX) mnemonic covering mechanism of action, toxicity, and side effects.
Digoxin is a cardiac glycoside medication used to treat heart disorders like atrial fibrillation and heart failure digoxin has a very narrow therapeutic range so dosage and patients must be monitored closely by the nurse to look out for side effects in this mnemonic video i’ll teach you my way to remember everything you need to know about digoxin so let’s jump in
We’ve made our way onto the field of a baseball game where tension is high first notice this digital camera in the foreground a cameraman is using this digital camera to take a picture of the player currently up to bat this digital camera is our symbol for digoxin because digital sounds a lot like digoxin right digoxin falls into the category of cardiac glycoside
Drugs digoxin works by increasing the strength of the heart’s contractions while decreasing the heart rate with the overall effect of making the heart pump blood more efficiently next let’s talk about when digoxin is used in the clinical setting something seems to be wrong with the digital camera this screen is full of irregular static by the way the static
On the digital camera screen should remind you of arrhythmias since the jagged irregular waves here look like the chaos and arrhythmia causes on an ekg next pay attention to that symbol in the corner of the screen i guess the reason why this camera has static is because it has a lot of satellite signal maybe for uploading the pictures it takes to the internet
Or something now i don’t know about you but to me that signal tower icon looks a lot like the letter a this a can help you remember that digoxin treats atrial arrhythmias since the atria starts with the letter a the most common atrial arrhythmia where digoxin is used is atrial fibrillation a condition in which the atria are beating so quickly that they appear
Like they are quivering or trembling the reason why these atrial arrhythmias are so dangerous is because the electrical impulses from the atria are conducted down to the ventricles where they cause the ventricles to beat extremely quickly as well and if you know your physiology you’d know that the ventricles require adequate time to fill in order to pump blood
Effectively so quick beating ventricles can cause poor cardiac output leading to cardiogenic shock and even death this is where digoxin comes in digoxin slows the heart rate allowing the ventricle’s time to fill to restore cardiac output got that let’s move on these fans are obviously not pleased with how the game is going they’re throwing things onto the
Field including this sign that says i love baseball except there is a big rip down the middle of the sign right through the heart this ripped heart is our symbol for heart failure get it a ripped heart for heart failure digoxin is also a very useful drug for patients in heart failure you see heart failure is caused when the heart fails to pump blood forward
Effectively like we’ve mentioned before digoxin helps in two ways by slowing the heart rate and strengthening each individual contraction which improves the overall efficiency of the heart this makes digoxin a very useful medication in treating heart failure but despite all of its good effects digoxin is a drug that comes with a lot of side effects let’s talk
About those next no wonder the fans are upset take a look at the scoreboard there are currently two strikes and two outs if you know anything about baseball you’d know that our team loses this inning if they get any more strikes or outs in other words you could say that 2 is the maximum allowable numbers of outs or strikes for this team this reminds me of
Digoxin’s therapeutic limit digoxin levels must not exceed 2 nanograms per milliliter you see digoxin is a drug with a notoriously narrow therapeutic range between 0.5 and 2 nanograms per milliliter this narrow range makes this a hard drug to use because too low of a dose means the drug will fail to achieve its effect while too high of a dose will cause side
Effects since the sweet spot in the middle is so narrow this means that most patients on digoxin will experience a lot of side effects for the nclex remembering the maximum dose of digoxin 2 nanograms per milliliter is extremely high yield generally a digoxin level will be measured and if this number exceeds two you should alert the provider just remember
Above two is bad both in this baseball game and with digoxin next let’s talk about what puts the patient at a higher risk of digoxin toxicity watch your head the angry fans are now throwing empty banana peels onto the field angry viewers often throw banana peels when they’re upset and one banana peel has landed on the digital camera that must have been what
Was causing the static earlier anyway here at pixarize we use bananas as our symbol for potassium because everybody knows bananas have a lot of potassium right and these falling empty banana peels are our symbol for low potassium or hypokalemia get it the risk of digoxin toxicity increases with hypokalemia note that i didn’t say that digoxin causes hypokalemia
But rather that low potassium levels will put the patient at increased risk for experiencing side effects that means that a patient on digoxin will need to carefully monitor their potassium levels as well as their digoxin levels in addition be careful of any other drugs that might decrease potassium like loop diuretics and cortisone so now we know that digoxin
Has a narrow therapeutic range and that side effects are often seen with low potassium but what are these side effects anyway well take a look at our baseball player in question this guy doesn’t look like he’s feeling very good i guess all that pressure of the moment is getting to his stomach making him feel queasy it probably doesn’t help that there’s all
These falling banana peels and that digital camera in his face you can use this queasy nauseous baseball player to help you remember the side effects of gi upset this includes things like nausea vomiting diarrhea and anorexia gi distress is one of the earliest and most important signs of digoxin toxicity so be sure to look out for this side effect and notify the
Provider so that the drug level can be corrected before the side effects get worse but the pressure of winning the game isn’t the only thing making the baseball player sick to his stomach with his last hit the baseball hit this turtle who was slowly making his way across the field yeah the fans didn’t like that very much and the baseball player feels awful about
It take a closer look at this turtle because i want you to notice that this turtle has a heart-shaped shell this slow turtle with a heart-shaped shell is our symbol for a slow heart rate remember that one of the major ways digoxin works is by slowing down fast heart rates well digoxin can also cause the heart rate to slow down too much and cause bradycardia
As the nurse make sure you assess your patient’s pulse for a full 60 seconds before administering digoxin if the heart rate is below 60 you should hold that dose and notify the provider this is a topic nclex just loves to ask you about so just remember this slow turtle with a heart-shaped shell and you’ll get this question right on test day with the intensity
Of the game’s score and the drama surrounding the injured turtle the media does not want to forget this moment the camera is snapping picture after picture and the flash on the camera is really bright this baseball player had to shield his eyes from the flash by the way getting blinded by the camera flash reminds me of the vision changes that happen with
Digoxin toxicity as digoxin toxicity gets more severe patients may experience some vision changes including blurred vision double vision and a unique white or yellow halo that appears around objects kind of like looking into a blinding flash and then seeing halos after on test day use this blinding flash to remind you that vision changes are a sign of digoxin
Toxicity alright last side effect before we wrap up and this one is an easy one let’s go back to the static on this camera screen if you remember from earlier in this video the static was our symbol for arrhythmia as it turns out arrhythmias are also a side effect of digoxin toxicity so digoxin is used to treat arrhythmias but can also cause them how does that
Work well anytime you use medications that alter the heart’s rhythm there’s always a risk of actually causing other types of rhythm disorders make sense alright that’s it for digoxin let’s quickly review everything we’ve learned digoxin is a cardiac glycoside that works by increasing the strength of the heart’s contractions and slowing down the heart rate it
Is used clinically to treat atrial fibrillation and heart failure digoxin has a narrow therapeutic range and side effects are seen with serum levels above 2 nanograms per milliliter the risk of toxicity is increased with hypokalemia so patients should have their potassium levels monitored closely and be extremely careful with other drugs that decrease potassium
Levels like loop diuretics and cortisone the earliest sign of digoxin toxicity is gi distress and later signs include bradycardia vision changes and arrhythmias always remember to monitor the apical pulse for a full minute before administration and don’t give the dose if the heart rate is less than 60 beats per minute alright that covers it for digoxin let’s
Wish our batter some luck and grab some cracker jacks to snack on gotta take advantage of this extra time you’ve saved by studying with pixar eyes i’ll see you in the next one thanks for watching for more videos like this one subscribe to our channel and check out our newest lessons for more resources on this topic including fact lists and interactive review
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Transcribed from video
Digoxin Nursing Pharmacology NCLEX Mnemonic | Mechanism of Action, Toxicity, Side Effects By Pixorize
