Sue Chalmers, a 75-year-old female, normally enjoys

Sue Chalmers, a 75-year-old female, normally enjoys good health. She has been treated with digoxin for atrial fibrillation for the past 10 years but maintains an independent and socially active life. For the past 5 days she had been feeling unwell and had vomited frequently in the last 24 hours. She calls the retirement village nurse who visits her immediately and ascertains that Sue feels nauseous, has lost her appetite and is a little confused and agitated. 1. Discuss the most likely explanation for her current gastrointestinal and CNS symptoms. 2. The nurse takes her pulse and is immediately concerned about the bigeminal rhythm. Sue is taken to hospital where a blood sample is drawn for electrolytes and for a digoxin plasma drug concentration. Discuss the mechanism of action of digoxin and explain why she has developed a bigeminal rhythm 3. Explain why a blood sample has been sent for analysis of electrolytes and to determine a plasma digoxin concentration.

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