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Received report from client’s LTC nurse. Client, who has a history of atrial fibrillation, had three episodes of vomiting in 24 hours and their heart rate this morning was 52 beats/min. Digoxin was held and provider was notified. Serum digoxin level at 0900 was 2.2 ng/dl (2.82 nmol/L). Client reports nausea, blurred vision, photophobia, and headache for last 24 hours. Client denies chest pain and shortness of breath. Cardiac monitor shows atrial fibrillation with a ventricular rate of 52 beats/min. Lungs are clear bilaterally. S1 and S2 heard on heart auscultation; no S3 or murmurs noted. No pedal edema noted; radial and dorsalis pedis pulses strong bilaterally. Client is alert and oriented to time, place, person, and events. Speech clear and coherent. No facial drooping observed. Hand grasps strong bilaterally. Skin is cool, dry, and pale. Active bowel sounds in all four quadrants. Vital signs: temperature, 98.2°F (36.8°C); heart rate, 52 beats/min; respiratory rate, 18 breaths/min; blood pressure, 108/64 mm Hg. Oxygen saturation, 96% on room air. Height, 70 in. (177.8 cm); weight, 148 lb. (67.1 kg); body mass index (BMI), 21.2.
SCIENCE
HEALTH SCIENCE
NURSING

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