A 52-year-old woman with atrial fibrillation for 2 years on digoxin presents with nausea, visual disturbances with yellow-green halos, and dizziness. Vital signs: BP 98/62 mmHg, HR 42 bpm, RR 16/min, Temp 37°C. Serum digoxin level is 2.8 ng/mL (therapeutic range 0.8-2.0 ng/mL). ECG shows multiple premature ventricular contractions. Potassium is 3.2 mEq/L. She denies chest pain. Which intervention is most appropriate?
- A)Increase digoxin dose to improve rate control
- B)Continue current dose; symptoms are unrelated to digoxin
- C)Add verapamil to enhance negative dromotropic effects
- D)Reduce digoxin dose; signs suggest toxicity despite therapeutic levelGABARITO
- E)Administer atropine to reverse bradycardia immediately
Explicação
The patient exhibits classic signs of digoxin toxicity: nausea, visual disturbances (yellow-green vision is pathognomonic), and bradycardia. These occur despite a 'therapeutic' serum level because toxicity is a clinical diagnosis based on symptoms, not just th... Ver explicação completa e trilha adaptativa →