The nurse calculates a 4 ml dose of prescribed digoxin for a 9-month-old infant. What action should the nurse implement?

• A. Suspect dosage error and do not give dose.
• B. Mix dose with juice to disguise its taste.
• C. Check heart rate and administer dose by placing it to the back and side of mouth.
• D. Check heart rate and administer dose by letting the infant suck it through a nipple.

Answer: (B)

Palatability and the need to ensure the full prescribed amount is given is the key idea here. Digoxin liquid can be bitter, and infants may refuse or spit out the dose. Mixing the digoxin with a small amount of juice helps mask the taste and makes swallowing more likely, so the infant actually receives the full 4 mL prescribed. After preparing, use a calibrated syringe to deliver the dose, guiding the liquid toward the back and side of the mouth to promote swallowing and reduce the risk of aspiration. The goal is to ensure the exact dose is ingested rather than being refused or wasted.