What should you do next if a patient's heart rate is 49 before administering digoxin (Lanoxin®)?

If a patient's heart rate is 49 beats per minute before administering digoxin, the appropriate next step is to report this finding to the RN or provider. Digoxin is a medication used to treat certain heart conditions, particularly atrial fibrillation and heart failure, but it can have significant effects on heart rate and rhythm. A heart rate below 60 beats per minute is considered bradycardia, which can lead to serious complications if digoxin is administered.

By notifying the RN or provider, you ensure that a trained professional can make an informed decision regarding whether it is safe to administer the medication or if further assessment is necessary. This is essential for patient safety, as healthcare providers may need to evaluate the situation further, determine the cause of bradycardia, and decide on an appropriate course of action which may include withholding the medication or initiating interventions to stabilize the patient's heart rate.

In this scenario, documenting the heart rate, administering the digoxin, or assessing blood pressure may not address the immediate concern surrounding the low heart rate and could potentially endanger the patient's wellbeing. Thus, reporting to the RN or provider is the critical step to ensure safe and effective patient care.