Nokea
A client is prescribed droxin IV as a loading dose. The nurse would expect to administer the drug over which time frame?
- A. 30 seconds
- B. 2 minutes
- C. 5 minutes
- D. 30 minutes
Correct Answer: C
Rationale: When a cardiotonic drug is given IV, it is administered slowly (over at least 5 minutes), and the administration site is assessed for redness or infiltration.
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A nurse is monitoring a client who is prescribed milrinone for heart failure. The nurse determines that the client is experiencing an adverse reaction based on assessment of which of the following?
- A. Edema
- B. Hypotension
- C. Bradycardia
- D. Cyanosis
Correct Answer: B
Rationale: When caring for clients taking milrinone, the development of hypotension indicates an adverse reaction. Edema and cyanosis need to be assessed by the nurse as part of the preadministration assessment. Edema, bradycardia, and cyanosis are not adverse reactions associated with milrinone.
Which of the following is true with regard to oral administration of cardiotonic drugs? Select all that apply.
- A. Capsule doses are less absorbed.
- B. Alternating between oral dosage forms is avoided.
- C. Tablets can be crushed and mixed with food or fluids.
- D. Oral dosage forms can be administered without regard to meals.
- E. The recommended dosage of the capsules is 80% more than that of tablets.
Correct Answer: B,C,D
Rationale: Oral preparations can be given without regard to meals. Tablets can be crushed and mixed with food or fluids if the patient has difficulty swallowing. Do not alternate between the dosage forms (i.e., tablets and capsules); these dosages are not the same. Owing to better absorption, the recommended dosage of the capsules is 80% of the dosage for tablets and elixir.
The nurse is caring for a client receiving a cardiotonic drug. The client has edema. Which assessment would be most important?
- A. Auscultation of bowel sounds
- B. Measurement of intake and output
- C. Observation of respiratory rate
- D. Observation of pulse rate
Correct Answer: B
Rationale: Measurement of intake and output would be most important for the client with edema who is receiving a cardiotonic drug. Auscultation of bowel sounds, observation of respiratory rate, and observation of pulse rate are interventions not related to edema in the client.
When reviewing the medical record of a client who is prescribed a cardiotonic, which condition would lead the nurse to contact the primary health care provider because the drug is contraindicated for use? Select all that apply.
- A. Digitalis toxicity
- B. Hypertension
- C. Cardiac tamponade
- D. Hypotension
- E. Ventricular tachycardia
Correct Answer: A,C,E
Rationale: The cardiotonics are contraindicated in the presence of digitalis toxicity and in clients with known drug hypersensitivity, ventricular tachycardia, cardiac tamponade, restrictive cardiomyopathy, or AV block.
A nurse checks the serum digoxin level of a client and finds it to be increased. Which of the following would the nurse identify as possibly associated with this increase?
- A. Colestipol (Colestid)
- B. Verapamil (Calan)
- C. Clarithromycin (Biaxin)
- D. Calcium carbonate (Maalox)
- E. Spironolactone (Aldactone)
Correct Answer: B,C,E
Rationale: Increased serum digoxin levels can occur with verapamil, clarithromycin, and spironolactone. Antacids, such as calcium carbonate, and colestipol cause a decrease in serum digoxin levels.