What are signs of digoxin toxicity in a PCU patient, and what monitoring is required?

• A. Nausea, vomiting, confusion, visual disturbances, bradycardia, or arrhythmias; monitor serum digoxin level and potassium; check for drug interactions.
• B. Hypertension and weight gain; monitor triglycerides.
• C. Abdominal pain only; monitor liver enzymes.
• D. Cough and wheeze; monitor spirometry.

Answer: (A)

Digoxin toxicity manifests in several interrelated ways: the GI system often shows up first with nausea and vomiting (sometimes accompanied by loss of appetite), the nervous system can present as confusion or altered mental status, and visual disturbances such as blurred vision or seeing yellow halos are classic. The heart is affected too, with bradycardia and potentially dangerous arrhythmias resulting from digoxin’s effect on conduction and automaticity. In a PCU patient, monitoring aims to keep digoxin levels within a safe range while watching electrolytes and kidneys, since low potassium or impaired clearance heightens toxicity risk. Regularly checking the serum digoxin level, monitoring potassium and renal function, and reviewing drug interactions that can raise digoxin levels are essential. Continuous ECG monitoring and frequent pulse checks help catch rhythm problems early.