A patient taking Digoxin has a potassium level of 2.8 mEq/L. What action should the nurse take?

• A. Administer the Digoxin as scheduled
• B. Hold the dose and notify the physician about the potassium level
• C. Assess the patient for edema
• D. Document normal potassium level

Answer: (B)

Low potassium increases the risk of digoxin toxicity. Digoxin works by inhibiting the Na+/K+-ATPase pump, and when potassium is low, more digoxin binds to these sites, enhancing its effects and raising the chance of dangerous arrhythmias. With a potassium level of 2.8 mEq/L, the safest action is to hold the digoxin dose and notify the physician so potassium can be corrected and the digoxin therapy reassessed. In the meantime, monitor for signs of toxicity—nausea, vomiting, loss of appetite, confusion, visual changes, and especially bradycardia or new/arrhythmic heart rhythms—and recheck potassium and digoxin levels as ordered. Administering the drug as scheduled would be unsafe given the hypokalemia; assessing edema doesn’t address the toxicity risk; and documenting the potassium as normal would be inaccurate.