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During a home visit to an 88-year-old client who is taking digoxin (Lanoxin) 0.25 mg daily to help control the rate or atrial fibrillation, you obtain this assessment information. Which finding is most important to communicate to the healthcare provider?
1. The client's apical pulse is 68 beats/min and irregularly irregular.
2. The client takes the digoxin with meals.
3. The client's vision is becoming fuzzy.
4. The client has lung crackles that clear after coughing.

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Answer: 1-  The client's apical pulse is 68 beats/min and irregularly irregular

Explanation:

Option one is the most important finding because, although it  showed apical pulse rate of 68, which is still within the normal range of 60-100, It pointed out that the pulse rate  is irregularly irregular.which may be  an indication of possible heart failure.

Besides, atrial fibrillation  was  explained with  this  option with the use of the words (irregularly irregular) ,and the use  of digoxin to speed heart rate.Therefore ,  indication of heart failure should be the main sign by the healthcare provider.  

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