Digoxin Dot — Digoxin Toxicity
Nausea, yellow-green halos, HR < 60 — check K⁺ and the level
Dot stops eating, calls the lights in her kitchen 'greenish,' and her pulse is 52. Her digoxin level is 2.4 and her potassium is 3.1.
Dot takes digoxin and a loop diuretic. The diuretic drops her potassium, and low potassium makes digoxin far more toxic even at a normal level. Early toxicity is vague: anorexia, nausea, fatigue, then visual halos and yellow-green vision, then bradycardia and dysrhythmias.
Read Digoxin Dot's full story →The story arc
The setup
Digoxin 0.125 mg daily plus furosemide for heart failure — a combination that quietly drains potassium.
The turn
She loses her appetite, feels sick after breakfast and blames the flu.
The crisis
She sees yellow-green halos around the lamps, her apical pulse is 48 and irregular, level 2.4 ng/mL, potassium 3.1.
The save
The dose is held, potassium is replaced, the apical pulse is counted for a full minute before every dose, and digoxin immune Fab stands ready for life-threatening dysrhythmias.
NCLEX study section — Digoxin Toxicity
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Pharmacology
Take this chapter into practice questions on the same topic.