A nurse is caring for a patient who is taking Digoxin. The nurse should instruct the patient to monitor and report which of the following adverse effects? ( select all the apply)

Correct Answer: A

Rationale: Digoxin is a medication commonly used to treat heart conditions such as heart failure and atrial fibrillation. Monitoring and reporting adverse effects of digoxin are crucial to ensure the patient's safety.

Correct Answer: A

Rationale: Pregnancy boosts lung perfusion, increasing inhaled drug absorption (e.g., anesthetics), a pharmacokinetic shift to note. Excretion may slow later, but not universally. Oral absorption isn't broadly reduced-GI changes vary. Avoiding all drugs is impractical-some conditions need treatment. Inhaled absorption informs safe use.

Correct Answer: A

Rationale: To evaluate the medical effectiveness of Metformin, it is essential to monitor serum glucose levels, as Metformin is commonly used to treat type 2 diabetes by decreasing glucose production in the liver and increasing insulin sensitivity in peripheral tissues. Monitoring serum electrolytes, ketones, blood pH, lactate, and pyruvate levels is also important because Metformin can potentially cause lactic acidosis, especially in patients with kidney or liver impairment. By assessing these parameters, healthcare providers can gauge the efficacy and safety of Metformin therapy. Checking for resolution of hypothyroidism and hormone normalization is not directly related to evaluating Metformin's effectiveness. Pain reduction and patient alertness are also not the primary indicators for assessing the medical effectiveness of Metformin in managing diabetes.

Correct Answer: B

Rationale: Steady-state concentration is reached after 4-5 half-lives, when drug input equals output. Digoxin's half-life is 40 hours (1.67 days). Four half-lives is 4 × 40 = 160 hours (6.67 days), and five is 200 hours (8.33 days). Over 90% steady state occurs around 4 half-lives, roughly 6-7 days. Two days (48 hours) is only ~1.2 half-lives, far too short. Ten days (~6 half-lives) exceeds 90%, but 7 days (~4.2 half-lives) aligns with >90% (e.g., 94% at 4 half-lives). Fourteen or 18 days overshoot unnecessarily. Seven days balances precision and practicality, guiding digoxin dosing timelines in heart failure or arrhythmias.

Correct Answer: D

Rationale: The best way to avoid problems with flushing or pruritus when taking niacin for antilipemic therapy is to take the medication with a full glass of water on an empty stomach. This method helps to minimize the chances of flushing or itching commonly associated with niacin therapy. Niacin can cause flushing by dilating blood vessels, leading to redness, warmth, and itching of the skin. Taking it on an empty stomach with water can help reduce the intensity of these side effects. Starting with a low initial dose and then gradually increasing it can also help to reduce flushing and other adverse effects associated with niacin therapy.