Digoxin Toxicity and Nursing Safety

Digoxin (Lanoxin) is a cardiac glycoside used for rate control in atrial fibrillation and as a positive inotrope in heart failure. It has one of the narrowest therapeutic windows of any medication — toxic levels overlap with therapeutic levels in sensitive patients. Digoxin toxicity causes characteristic GI symptoms (nausea, vomiting, anorexia), visual disturbances (yellow-green halos, blurred vision), and potentially fatal cardiac dysrhythmias including bradycardia, AV block, and ventricular dysrhythmias. NCLEX-RN tests nurses on the specific toxic signs, the critical safety check (hold digoxin if HR < 60 bpm), and the antidote (digoxin immune Fab). Digoxin toxicity is one of the most common "never skip your assessment" test questions on pharmacology items. On the exam, writers often pair stable-sounding options with unstable data—notice the mismatch before you commit. If the stem names a license or role, reread that line; scope errors are classic trap answers even when the clinical topic is familiar. Run a 60-second scan: breathing work and oxygenation, perfusion and end organs, neuro baseline, likely infection sources, and devices that can fail quietly. When two answers feel partly right,...