Managing Heart Failure and Atrial Fibrillation with Digoxin: Dosage Calculation Guide

When dealing with a 70-year-old male patient grappling with a history of heart failure and atrial fibrillation, precision and knowledge in medication administration become paramount. The prescribed medication, digoxin (commonly known as Lanoxin) in a dosage of 0.25 mg taken orally daily, is a vital component of his treatment plan. However, when the pharmacy dispenses digoxin tablets at a strength of 0.125 mg, the question arises: how many tablets of digoxin 0.125 mg should the nurse administer to ensure proper symptom management?

Understanding Heart Failure and Atrial Fibrillation

Before delving into the dosage calculation, it’s essential to understand the medical conditions at hand. Both heart failure and atrial fibrillation are chronic heart conditions that can significantly impact an individual’s life.

  • Heart Failure: Heart failure is a condition where the heart’s ability to pump blood is compromised. It can result from various factors, including coronary artery disease, high blood pressure, and heart valve disorders. Patients with heart failure often experience symptoms such as shortness of breath, fatigue, and fluid retention.
  • Atrial Fibrillation: Atrial fibrillation is an irregular and often rapid heart rate that can lead to various complications, including stroke and heart failure. It is characterized by the quivering or irregular beating of the atria (the heart’s upper chambers).

The Role of Digoxin in Treatment

Digoxin is a medication commonly prescribed for individuals with heart conditions, including heart failure and atrial fibrillation. It belongs to a class of drugs known as cardiac glycosides and works by increasing the force of contractions in the heart. This can help regulate heart rate and improve symptoms in patients with these conditions.

Dosage Calculation for Digoxin

In our patient’s case, the physician has prescribed a daily dosage of 0.25 mg of digoxin. However, the tablets provided by the pharmacy are 0.125 mg each. To calculate the correct number of tablets to administer, a simple mathematical calculation is required.

The goal is to provide the patient with 0.25 mg of digoxin daily. Since each tablet contains 0.125 mg, the patient should be given two tablets daily to achieve the prescribed dosage.

Nurse’s Role in Medication Administration

While dosage calculation is essential, the role of a nurse in ensuring safe and effective medication administration cannot be overstated. Here are key steps to consider when administering digoxin or any medication:

  1. Patient Assessment: Before administering any medication, assess the patient’s medical history, allergies, and overall condition. Ensure that digoxin is the appropriate choice for the patient.
  2. Informed Consent: Explain the purpose of the medication, potential side effects, and expected outcomes to the patient or their caregiver. Obtain informed consent before administration.
  3. Medication Administration: Administer the medication as prescribed, keeping a sharp eye on factors like dosage, route, and timing. In the case of digoxin, oral administration is typical.
  4. Monitoring: After administering the medication, closely monitor the patient for any adverse reactions or signs of improvement. This may include vital sign assessments and symptom evaluation.
  5. Documentation: Thoroughly document the medication administration, including the dosage, date, time, and the patient’s response. Accurate and timely documentation is essential for continuity of care.


The proper management of heart failure and atrial fibrillation, especially in elderly patients like the 70-year-old male in our scenario, requires a comprehensive approach. Digoxin, when administered correctly, can play a pivotal role in controlling symptoms and improving the patient’s quality of life.

In summary, to provide a daily dosage of 0.25 mg of digoxin to the patient when using 0.125 mg tablets, two tablets should be administered. Nurses must not only ensure the accurate calculation and administration of the medication but also focus on patient assessment, informed consent, monitoring, and meticulous documentation. This holistic approach guarantees that the patient receives the best care possible in their battle against heart failure and atrial fibrillation.


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