Nokea
A client with heart failure has been digitalized. The client requires long-term digoxin therapy. Which of the following instructions should the nurse provide the client on discharge?
- A. Take the drug with high-fiber meals.
- B. Report to the center if the pulse is less than 70 \mathrm{bpm}.
- C. Take antacids promptly to avoid gastric problems.
- D. Take the drug regularly without skipping a dose.
Correct Answer: D
Rationale: The nurse should instruct the client to take the drug regularly without skipping a dose. The client should consult the provider before discontinuing the drug. Taking the drug with high-fiber meals will decrease the absorption of the drug. The client should be advised to report to the center if the pulse is less than 60 \mathrm{bpm}. Antacids should not be taken as they alter the plasma digoxin levels.
You may also like to solve these questions
A nurse would administer the prescribed digoxin (Lanoxin) cautiously for a client with which electrolyte imbalances? Select all that apply.
- A. Hypokalemia
- B. Hypermagnesemia
- C. Hypocalcemia
- D. Hyperkalemia
- E. Hypomagnesemia
Correct Answer: A,C,E
Rationale: The cardiotonic drugs are given cautiously to clients with electrolyte imbalances (especially hypokalemia, hypocalcemia, and hypomagnesemia).
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.
After teaching a client about his prescribed cardiotonic drug therapy, the nurse determines that additional teaching is needed when the client states which of the following?
- A. I will take the drug at the same time each day.'
- B. I can crush the tablet and mix it with food.'
- C. I should call if my pulse rate is below 80 beats per minute.'
- D. I need to notify my doctor if I have blurred vision.'
Correct Answer: C
Rationale: The client should call the primary health care provider if his pulse rate is below 60 beats per minute or above 100 beats per minute. The client should take the drug at the same time each day, crush the tablet and mix with food, and notify the primary health care provider if blurred vision occurs.
A client has been admitted to a health care center with complaints of dyspnea. The nurse suspects left-sided heart failure based on assessment of which of the following?
- A. Nocturia
- B. Pitting edema
- C. Weight gain
- D. Orthopnea
Correct Answer: D
Rationale: The nurse should assess for orthopnea in clients with left-sided heart failure. Orthopnea is a condition where the client experiences difficulty in breathing on lying down. The other features of left ventricular failure include a hacking cough or wheezing, restlessness, and anxiety. Nocturia, pitting edema, and weight gain are associated with right-sided heart failure.
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.