In this video I break down the medication Digoxin. I discuss the side effects, nurse’s role and patient education. I also discuss Digoxin toxicity and what can be done about it.
Hi everybody i am that nursing puff and welcome to my channel in today’s video we’re talking all about the jackson so what’s it for who uses it what are the side effects what does the nurse need to know what’s important patient education all of that stuff so let’s get into it so the first thing we need to know is what does it do right so it helps make the heartbeat
Stronger and with a more regular rhythm it does this by making calcium more available for contractile proteins which will result in an increase of our cardiac output increase of the force of the contraction decrease in the heart rate and decrease in the av conduction speed so all of that is the heart is going to work better and pump more blood to the body so
That’s what it does okay it causes the heart to work better more efficiently and to pump more blood to the body so now let’s talk about what type of patient would be on digoxin and what are some side effects to look out for now let’s talk about some of the uses of this medication so this is commonly given to patients who are in heart failure cardiogenic shack
Afib a flutter or atrial tachycardia and you’ll note a theme with these something that these have in common in all of these diseases the heart is pumping and emptying in efficiently okay so it’s not working as good as it should and what’s to jackson’s job it’s to make it more efficient so that’s why all of these would get this medication when it comes to side
Effects nausea vomiting and diarrhea those would be the most common most typical side effects that’s why i put the little star next to them the rest of these aren’t as common and actually some of them are signs of toxicity so fast or slow or uneven heart rate and that one makes a little bit of sense right because that’s kind of what this medication does it slows
Your heart rate it messes with your heart rate so it can change it it can cause dizziness especially if you get too low if you get two bradycardic confusion or overall weakness hallucinations blurry vision or a headache so these are the uses and the side effects for digestion now let’s talk about the nurses role now let’s talk about nursing care so the first
Thing is the nurse needs to assess the apical pulse for one full minute before giving and this is every time you give it not just the first time but every time you administer this medication you want to make sure you assess the pulse for one full minute because remember this can lower your pulse okay it can decrease your heart rate so if the patient already has
A low pulse if they’re already bradycardic you might want to hold this medication so very important we’re going to monitor the electrolytes and renal function studies monitor the dig levels so normal therapeutic range is 0.5 to 2 so anything higher than this is considered toxic and anything lower than this just really isn’t very effective they’re going to be on
Strict ino we’re going to weigh them daily we’re going to assess their lung sounds check for edema and assess their cardiac status because obviously this is going to affect the heart and then the final thing the nurse has to do is lots and lots of patient education and actually it is quite a bit of patient education so i wanted to talk specifically about that
Now let’s talk about patient education so some things we need to teach our patients of course the signs and symptoms of toxicity what to look out for we want to encourage them to keep their appointments because they are going to have routine appointments to get their dige levels done the renal function studies done so we want to make sure that they’re attending
Those appointments we want to encourage a diet rich in potassium and low in sodium we need to teach them how to take their pulse so how to check your heart rate before you would give yourself the med so just like us as the nurse we need to take the apical pulse for a full minute before we would administer we need to teach the patient how to check their own heart
Rate before they would take it at home we need to let them know that they have to inform the doctor about all medications and supplements unfortunately this medication has a lot of interactions with herbal supplements and over-the-counter meds even like cough medicine so really important that the patient lets us know what over-the-counter meds prescription meds
Or supplements vitamins all of that we need to know all of that information to make sure that there’s no interactions we want to encourage them to take it at the same time every single day and to never abruptly stop it so if they’re going to be stopping the medication they’re going to be doing so under the direction of the physician they’re not just going to say
You know what i’m done i don’t want to take it anymore okay because that of course could have dangerous side effects on their heart we want to encourage them to wear an emergency id so maybe like an emergency tag or a bracelet just letting people know that they’re on this medication and then to call the doctor’s office if they’re showing any signs of toxicity so
I feel like i’ve been hinting about this the whole video but we need to talk about toxicity okay this is very very important so i’m going to talk about the signs and symptoms who’s at risk and is there an antidote is there something we can do about it so signs and symptoms the first signs and symptoms are normally like gi symptoms like nausea vomiting anorexia
Which is loss of appetite and diarrhea as it gets more serious we have headaches confusion potentially hallucinations they can report vision changes such as blurry vision or like seeing halos around like lights and lamps you know bright things and then even heart palpitations so these are the signs and symptoms they need to look out for and they would need to
Report to the doctor right away who’s at risk technically anybody taking this medication would be at risk right but certain groups of people are more at risk that includes people who have low amounts of potassium which is why we encourage them to have a diet rich in potassium high amounts of calcium are low amounts of magnesium those who are also taking calcium
Channel blockers at the same time and the elderly and is there anything we can do about it yes there is thank goodness right we do have an antidote and that is digoxin immune fab and this is probably out of all of the medications and antidotes you’re going to have to learn in nursing school the easiest one to remember because it has the name right in it okay so
There is an antidote we can give that if their levels get too high the big thing here is to prevent this from happening in the first place and that requires good patient education so letting them know what the signs and symptoms of toxicity are what to report not to mix you know other medications and supplements and to keep those appointments to get their dige
Levels taken that’s the key so this is toxicity and this whole thing has been to jackson i hope you found this helpful don’t forget to like and subscribe if you have any questions or comments please let me know and if not i’ll see you on the next one
Transcribed from video
PHARMACOLOGY REVIEW: DIGOXIN By That nursing prof
