Before administering digoxin to an infant with CHF, what should the nurse specifically assess?

Administering digoxin to an infant, particularly in the context of congestive heart failure (CHF), necessitates a specific focus on the apical pulse rate. This is critical because digoxin has a narrow therapeutic window, and its effects on the heart can lead to toxicity if not carefully monitored.

Digoxin works by increasing the force and efficiency of heart contractions, which is essential for managing CHF. However, it can also slow the heart rate, and in infants, a bradycardic pulse (a pulse rate that is slower than normal) can indicate impending toxicity or an adverse reaction to the medication. Before administering digoxin, healthcare professionals typically assess the apical pulse for a full minute; if the pulse is below the recommended threshold (usually around 90-110 beats per minute for infants), digoxin administration may need to be held or adjusted based on the healthcare provider’s guidance.

While assessing an infant's temperature, respiratory rate, and skin condition may provide additional information on the child's overall health status, these evaluations are not as directly related to the safety and efficacy of digoxin therapy as the apical pulse assessment. Thus, determining the apical pulse rate is crucial in ensuring that the medication is administered safely.