Howard Woods is an 85-year-old male who suffered a fall at home that resulted in a hip fracture. Surgical repair was delayed by 2 days because Mr. Woods needed cardiac clearance for surgery due to his history of atrial fibrillation and the need to ensure that he was on therapeutic levels of digoxin. His current medications include digoxin, warfarin, opioids, and ibuprofen.

Mr. Woods is recovering on the medical-surgical unit and working with physical therapy for ambulation with a walker. The discharge plan is to transfer him to inpatient rehab for a few weeks to ensure that he is ambulating safely before returning home. Mr. Woods lives alone in a single-level apartment.

Monitoring for therapeutic blood levels of medications is important in the care of the older adult. Discuss the medications this patient is taking and the laboratory orders the nurse would expect to monitor.
What are the expected therapeutic blood levels of INR and digoxin?
What nursing intervention would be completed with the administration of digoxin?
Mr. Woods is preparing for discharge to the inpatient rehab. After ambulating 20 feet with the physical therapist, he complains of bilateral calf pain and returns to bed. Discuss the nursing priorities with this scenario.


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