A patient with heart failure is taking digoxin. Which assessment finding indicates a therapeutic effect?

• A. Heart rate 58 beats per minute
• B. Heart rate 110 beats per minute
• C. Urinary output 40 mL/hr
• D. Blood pressure 90/50 mm Hg

Answer: (A)

Digoxin helps heart failure by boosting the heart’s contractility and by increasing vagal tone, which slows conduction through the AV node. The therapeutic effect often comes with a modest drop in heart rate as the heart works more efficiently and doesn’t need to beat as quickly. A heart rate of 58 beats per minute fits this pattern of improved cardiac function with slowed conduction, indicating the drug is exerting its intended effect, assuming the patient isn’t symptomatic from bradycardia.

A heart rate of 110 bpm would point to ongoing tachycardia, not the digoxin effect. Urine output alone isn’t a direct measure of digoxin response, and a blood pressure of 90/50 mm Hg signals hypotension, which isn’t a sign of therapeutic effect and could indicate issues needing attention.