An 18-month-old with a congenital heart defect is prescribed digoxin twice daily. Which statement should the nurse give the parents?

An 18-month-old with a congenital heart defect is prescribed digoxin twice daily. Which statement should the nurse give the parents?

• A. Digoxin enables the heart to pump more effectively with a slower and more regular rhythm
• B. Signs of toxicity include increased pulse and visual disturbances
• C. Digoxin is absorbed better if taken with meals
• D. If the child vomits within 15 minutes of administration, the dosage should be repeated

Answer: (A)

Digoxin works by increasing the heart’s pumping strength (positive inotropy) and by slowing conduction through the AV node, which lets the ventricles fill more completely and results in a slower, more regular rhythm. In a toddler with a congenital heart defect, this combination helps improve cardiac output and tissue perfusion, reducing symptoms like fatigue and poor feeding. Emphasize to parents that the medicine makes the heart work more efficiently, not just make it beat slowly for no reason. Toxicity isn’t signaled by a rising pulse; in fact, digoxin toxicity more commonly produces bradycardia, along with poor feeding, vomiting, or lethargy, and sometimes vision changes in some patients. The medication isn’t reliably improved in absorption simply by taking it with meals, and if vomiting occurs, repeating the dose is not routinely advised—clinical guidance should be sought for whether a repeat dose is appropriate. Encourage careful monitoring of the child’s pulse before dosing and to contact the clinician if the heart rate is notably slow or if any signs of toxicity appear.

Digoxin works by increasing the heart’s pumping strength (positive inotropy) and by slowing conduction through the AV node, which lets the ventricles fill more completely and results in a slower, more regular rhythm. In a toddler with a congenital heart defect, this combination helps improve cardiac output and tissue perfusion, reducing symptoms like fatigue and poor feeding. Emphasize to parents that the medicine makes the heart work more efficiently, not just make it beat slowly for no reason.

Toxicity isn’t signaled by a rising pulse; in fact, digoxin toxicity more commonly produces bradycardia, along with poor feeding, vomiting, or lethargy, and sometimes vision changes in some patients. The medication isn’t reliably improved in absorption simply by taking it with meals, and if vomiting occurs, repeating the dose is not routinely advised—clinical guidance should be sought for whether a repeat dose is appropriate. Encourage careful monitoring of the child’s pulse before dosing and to contact the clinician if the heart rate is notably slow or if any signs of toxicity appear.