A Digoxin level of 2.5 ng/mL is detected. What action should the nurse take?

• A. Administer the next scheduled dose
• B. Hold the dose and notify the physician
• C. Increase the dose to reach therapeutic levels
• D. Do nothing and monitor

Answer: (B)

Digoxin has a very narrow therapeutic window, so serum levels must stay within a small range to balance improved heart contractility with minimized toxicity risk. A level of 2.5 ng/mL is above the upper end of the therapeutic range (about 0.5–2.0 ng/mL), which increases the likelihood of digoxin toxicity and potentially dangerous cardiac effects.

Therefore, the nurse should withhold the next dose and notify the physician for further instructions. The physician may order a repeat level, adjust the dose, or take other measures based on the patient’s symptoms and overall condition. In the meantime, assess the patient’s pulse and rhythm, monitor electrolytes and renal function, and look for signs of toxicity such as nausea, vomiting, confusion, vision changes, or bradycardia.