Answer: D: Obtain an order for serum digoxin level
Request digitalis blood level is the best action as digitalis toxicity is suspected. Obtaining an order for a serum digoxin level is a specific action that may be necessary in this case, especially if Mrs. McLean has a history of taking digoxin or if her symptoms and vital signs are suggestive of digoxin toxicity. The decision to obtain this specific test would depend on the nurse's assessment and clinical judgment.
In the initial assessment and management of a patient with symptoms like confusion, nausea, and vision changes, it's crucial to perform a comprehensive evaluation, including assessing vital signs and oxygen levels, as I mentioned earlier. Once the nurse has gathered sufficient information, if there is suspicion of digoxin toxicity based on the patient's history or clinical findings, obtaining an order for a serum digoxin level would indeed be an appropriate next step.
Therefore, the nurse may consider obtaining an order for a serum digoxin level after the initial assessment and evaluation, especially if there is reason to suspect that digoxin toxicity may be contributing to Mrs. McLean's symptoms.
