During discharge, what critical instruction should the nurse provide regarding digoxin?

The critical instruction for a patient or caregiver regarding digoxin is to check the pulse and hold the medication if it is low. Digoxin is a cardiac glycoside that has a narrow therapeutic window, and its effectiveness and safety are reliant on maintaining an appropriate heart rate.

When digoxin is prescribed, it is essential to monitor the heart rate because the drug can slow down the heart. If the pulse is below a certain threshold (usually under 60 beats per minute in adults, but this can vary in children), it indicates that the heart may be under stress or not functioning properly. In such cases, administering digoxin could result in toxicity or other adverse effects. Therefore, checking the pulse before giving the medication is a critical safety measure to ensure that it is appropriate to proceed with the dosage.

Other options, while relevant in certain contexts, do not provide the same level of essential instruction tied directly to patient safety regarding digoxin administration. For instance, increasing the dosage with tachycardia could lead to overdose, administering digoxin with food may not be generally recommended due to potential absorption issues, and monitoring for allergic reactions is important but not as critical directly related to the safe administration of digoxin as pulse monitoring is.