HESI Registered Nurse EXIT Practice Exam

What would the nurse expect to find when evaluating the therapeutic effectiveness of Lanoxin (digoxin) in a client with heart failure?

1. Diaphoresis with decreased urinary output

2. Increased heart rate with increased respirations

3. Improved respiratory status and increased urinary output

4. Decreased chest pain and decreased blood pressure

The correct answer is: Improved respiratory status and increased urinary output

When evaluating the therapeutic effectiveness of Lanoxin (digoxin) in a client with heart failure, the expectation of improved respiratory status and increased urinary output is based on the medication's mechanism of action. Digoxin works by increasing the force of myocardial contractions, which improves cardiac output. An increase in cardiac output leads to better circulation, ultimately reducing symptoms of heart failure, including respiratory distress. As the heart's efficiency improves, the lungs typically become less congested, which enhances the respiratory status of the patient. Additionally, adequate renal perfusion is a direct outcome of improved cardiac function. With better blood flow to the kidneys, the expected result is an increase in urinary output, indicating that the kidneys are functioning well and effectively excreting excess fluid that often accumulates in heart failure cases. This outcome aligns with the goals of therapy for heart failure, which include alleviating symptoms, improving functional status, and enhancing overall quality of life for the patient.