Pharmacological and Parenteral Therapies

Digoxin with a low potassium: give or hold?

Original RemoteNurse question · Last reviewed 2026-10-14

A client with heart failure takes digoxin once daily. Before the morning dose, the nurse finds an apical pulse of 72 beats per minute and a serum potassium of 3.1 mEq/L. What should the nurse do?

AGive the dose, because the apical pulse is above 60.
BGive half the dose and recheck the potassium tomorrow.
CHold the dose and report the potassium level to the prescriber.
DGive the dose with a banana or orange juice to raise the potassium.

Show the answer and rationale

Correct answer: C

A. Incorrect. The pulse is only one check. A low potassium raises the risk of digoxin toxicity even when the heart rate looks normal.
B. Incorrect. A nurse cannot change a prescribed dose. Changing it is the prescriber's decision once they know the potassium level.
C. Correct. The digoxin label lists hypokalemia among the conditions that may predispose to digoxin toxicity. A potassium of 3.1 mEq/L is low, so standard nursing practice is to hold the dose and report the result, and the prescriber decides on potassium replacement and the next dose.
D. Incorrect. Food will not correct the potassium before the dose acts, and the nurse would be giving digoxin to a client at higher risk of toxicity without telling the prescriber.

Source: FDA-approved label: Lanoxin (digoxin) tablets, on DailyMed

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