## Pharmacology Digoxin #1

### Question

The nurse receives an order form the health care provider which is described as: “Digoxin .125 mg P.O. once daily.” To prevent a dosage error, how should the nurse transcribe this order onto the medication administration record?

### Answers

- Digoxin .1250 mg P.O. once daily
- Rationale:
This answer is not correct because a zero should not be placed at the end of a decimal number (such as .1250). Instead, the appropriate transcription is 0.125 mg. When transcribing a digoxin prescription the nurse should be careful to place a zero to the left or in front of the decimal point (if no number in front) but not add a zero at the end if there are numbers to the right of the decimal point.

- Rationale:
- Digoxin .125 mg P.O. once daily
- Rationale:
This answer is not correct because a zero should be placed in front of a decimal point with no number. In other words, the appropriate transcription is “0.125 mg”, not “.125 mg”. When transcribing a digoxin prescription the nurse should be careful to place a zero to the left or in front of the decimal point (if no number in front) but not add a zero at the end if there are numbers to the right of the decimal point.

- Rationale:
**Digoxin 0.125 mg P.O. once daily**- Rationale:
This answer is correct because when transcribing a digoxin prescription the nurse should be careful to place a zero to the left or in front of the decimal point (if no number in front) but not add a zero at the end if there are numbers to the right of the decimal point. For example, the appropriate transcription is 0.125 mg, not .125 or .1250.

- Rationale:
- Digoxin 0.1250 mg P.O. once daily
- Rationale:
This answer is not correct because when transcribing a prescription with numbers to the right of a decimal, an extra zero should not be added to the end. For example, “0.1250 mg” is not correct, but “0.125 mg” is correct.

- Rationale:

### Overview

Digoxin is in the medication class of cardiac glycosides and has a high risk of toxicity. Digoxin toxicity can be lethal due to its narrow therapeutic range of 0.5-2.0 ng/mL, therefore, it is especially crucial for the correct dosage to be administered.

### Explanation

The answer is C. The zero before a decimal point will ensure that the amount is not misread. The zero should never be at the end as it might be misread leading to a multi-fold increase in the dosage.

### Learning Outcomes

Digoxin is a cardiac glycoside medication used to either improve contractility and efficiency of the heart in heart failure or to control an arrhythmia, such as atrial fibrillation. Digoxin has a high risk of toxicity due to its narrow therapeutic range of 0.5-2.0 ng/mL, therefore, it is especially crucial for the correct dosage to be administered. When transcribing a digoxin prescription the nurse should be careful to place a zero to the left or in front of the decimal point (if no number in front) but not add a zero at the end if there are numbers to the right of the decimal point. For example, the appropriate transcription is 0.125 mg, not .125 or .1250.

### Test Taking Tip

When transcribing a prescription the nurse should be careful to place a zero to the left or in front of the decimal point (if no number in front) but not add a zero at the end if there are numbers to the right of the decimal point. For example, the appropriate transcription is 0.125 mg, not .125 or .1250.