If an adult client's apical pulse is below 60, what should be done regarding digitalis administration?

When the apical pulse of an adult client is below 60 beats per minute, it is critical to hold or withhold the administration of digitalis. Digitalis (digoxin) is a cardiac glycoside used to treat heart conditions such as atrial fibrillation and heart failure. One of the central effects of digitalis is to increase the force of cardiac contraction and to slow down the heart rate through its action on the vagus nerve.

A heart rate that is lower than 60 beats per minute can signify bradycardia, which can be exacerbated by the administration of digitalis, leading to potential toxicity and serious complications. The low heart rate indicates that the heart may not be able to handle the additional workload that digitalis imposes.

Withholding digitalis when the apical pulse is below the threshold protects the patient from possible adverse effects and allows for further assessment of the patient's condition. After monitoring and reassessing the client, consultation with a physician is appropriate to determine the next steps, including whether to adjust treatment. Therefore, in the context of patient safety and medication management, not giving digitalis is the recommended approach.