Digoxin: Uses, Effects, Monitoring, and Toxicity Signs in Cardiac Care

What is digoxin used for?

Heart failure and control of certain dysrhythmias.

How does digoxin affect heart rate?

It decreases/slows the heart rate.

How does digoxin affect cardiac contraction?

It increases the force of cardiac contraction.

How does digoxin make the heart work more efficiently?

It slows conduction through the SA/AV nodes while increasing contraction strength.

What is the therapeutic digoxin level?

0.5-2 ng/mL.

What heart rate requires digoxin to be held?

Hold digoxin if the apical pulse is less than 60 bpm in an adult.

What should the nurse assess before giving digoxin?

Check the apical pulse/heart rate and rhythm.

What electrolyte is especially important with digoxin?

Potassium (K⁺).

Why is a low potassium level dangerous with digoxin?

Hypokalemia increases the risk of digoxin toxicity.

What potassium level is considered the lower end of the normal range?

About 3.5 mEq/L; low K⁺ increases digoxin toxicity risk.

What visual changes can occur with digoxin toxicity?

Halos, spots/floaters, blurred vision, or color changes.

What GI symptoms can indicate digoxin toxicity?

Nausea, vomiting, diarrhea, and loss of appetite.

What cardiac symptoms can occur with digoxin toxicity?

Irregular heart rate, bradycardia, or heart block.

What neurologic symptoms can occur with digoxin toxicity?

Confusion, weakness, and drowsiness.

What are signs of digoxin toxicity?

Visual halos/changes, N/V/D, anorexia, irregular HR, bradycardia, confusion, weakness, and drowsiness.

How does digoxin help a patient with heart failure?

It increases cardiac contraction and can improve symptoms such as edema.

What indicates digoxin is effective?

Improved cardiac response, controlled symptoms/HR, and stable blood pressure.

What should a patient taking digoxin be taught about their pulse?

Check the pulse and notify the provider if the HR is below 60 bpm.

When should digoxin be taken?

At the same time every day.

Digoxin brand name

Lanoxin

Digoxin drug class

Cardiac glycoside; inotrope

Digoxin therapeutic use

Treats mild to moderate heart failure and helps control dysrhythmias

Digoxin action

Decreases heart rate and increases force of cardiac contraction

Digoxin effect on SA/AV nodes

Slows conduction of electrical impulses through the SA and AV nodes

Digoxin therapeutic level

0.5-2 ng/mL

When should digoxin be held?

Hold and notify provider if adult HR is less than 60 bpm

Digoxin and potassium

Monitor K⁺ because hypokalemia increases the risk of digoxin toxicity

Digoxin toxicity visual signs

Halos, spots/floaters, color changes, and blurred vision

Digoxin toxicity GI signs

Nausea, vomiting, diarrhea, and loss of appetite

Digoxin toxicity cardiac signs

Irregular HR, bradycardia, or heart block

Digoxin toxicity neurologic signs

Confusion, weakness, and drowsiness

What should be monitored with digoxin?

Heart rate, rhythm, digoxin level, potassium level, and signs of toxicity

Signs digoxin is effective

Improved cardiac response, controlled HR/symptoms, and stable blood pressure

Digoxin patient teaching

Check pulse, report HR under 60, and report signs of toxicity

When should digoxin be taken?

At the same time every day

Digoxin missed dose

Take ASAP unless it is too late; then contact the provider

Digoxin and hypokalemia

Hypokalemia makes a patient more susceptible to digoxin toxicity

dig med admin levels

0.125-0.25.may be up to 0.5 per day