What is the most appropriate intervention when a child experiences frequent vomiting after taking digoxin?

When a child experiences frequent vomiting after taking digoxin, withholding the next dose if vomiting occurs is the most appropriate intervention. Digoxin is a medication that can be toxic if not administered correctly, and vomiting may indicate that the child is unable to retain the medication in their system.

Withholding the dose helps prevent further gastrointestinal irritation and reduces the risk of potential digoxin toxicity. In a clinical setting, it is critical to consider the child’s overall condition, as frequent vomiting may reflect underlying issues that need to be addressed.

In contrast to repeating the dose, which could exacerbate toxicity and persistence of symptoms, or monitoring closely without taking any action, which could leave the child at risk for further vomiting and complications, withholding the dose prioritizes the safety and well-being of the child. Additionally, administering another antiemetic does not address the root cause of the vomiting related to the digoxin intake and may not be an effective solution without first determining why the child is vomiting. Thus, the decision to withhold the next dose aligns with safe medication administration practices and follows the principle of "do no harm."