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

  1. 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.

  2. 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.

  3. 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.

  4. 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.

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.

Video Rationale