Pharmacological and Parenteral Therapies Q 93

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Which of the following should the nurse teach the client about the signs of digitalis toxicity?

  

     A. Increased appetite

     B. Elevated blood pressure

     C. Skin rash over the chest and back

     D. Visual disturbances such as seeing yellow spots

    

    

Correct Answer: D. Visual disturbances such as seeing yellow spots

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Seeing yellow spots and colored vision are common symptoms of digitalis toxicity. Of note visual changes especially changes involving colors such as seeing a yellow hue are better known and specifically seen in digitalis toxicity. Other visual problems include photophobia, photopsia and diminished visual acuity.

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Option A: GI symptoms of digitalis toxicity include anorexia and weight loss. Most symptoms are nonspecific findings and include a headache, malaise, insomnia, altered mental status, abdominal pain, nausea, and vomiting.

Option B: Hypotension is one of the cardiac symptoms of digitalis toxicity. There is no specific arrhythmia for digoxin toxicity rather a range of arrhythmias can be present such as various degrees of AV block, premature ventricular contractions, bradycardia, and even ventricular tachycardia. Cardiac arrhythmias are the main cause of death for those with digoxin toxicity.

Option C: There are no skin rashes in patients with digitalis toxicity. History of exposure is necessary to determine if poisoning is acute or chronic. Most reported poisonings result from chronic toxicity. Clinical signs of toxicity include gastrointestinal, neurological and the most concerning cardiac.

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