When should digoxin be withheld in a pediatric patient?

When should digoxin be withheld in a pediatric patient?

• A. Pulse less than 70 beats per minute
• B. Pulse less than 90 beats per minute
• C. Respiratory rate less than 12 breaths per minute
• D. Temperature above 38 C

Answer: (B)

Digoxin can slow the heart by affecting the AV node, and in children the heart rate is often higher to begin with. If the pulse drops too low, giving digoxin can push it into dangerous bradycardia. A pulse under 90 beats per minute is a safety cutoff used to withhold the medication and notify the clinician. Other signs like a respiratory rate under 12 or a fever above 38 C aren’t the standard triggers for withholding digoxin on their own, though they may warrant broader assessment for other issues. Monitoring for signs of digoxin toxicity—nausea, vomiting, dizziness, vision changes, or new arrhythmias—remains important alongside this threshold.

Digoxin can slow the heart by affecting the AV node, and in children the heart rate is often higher to begin with. If the pulse drops too low, giving digoxin can push it into dangerous bradycardia. A pulse under 90 beats per minute is a safety cutoff used to withhold the medication and notify the clinician. Other signs like a respiratory rate under 12 or a fever above 38 C aren’t the standard triggers for withholding digoxin on their own, though they may warrant broader assessment for other issues. Monitoring for signs of digoxin toxicity—nausea, vomiting, dizziness, vision changes, or new arrhythmias—remains important alongside this threshold.