Nokea
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.
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A client comes to the clinic for a visit. The client has been taking digoxin for several months. While interviewing the client, the nurse suspects the client is experiencing digoxin toxicity based on which of the following? Select all that apply.
- A. Anorexia
- B. Weakness
- C. Inability to relax
- D. Photosensitivity
- E. Disorientation
Correct Answer: A,B,E
Rationale: Signs of digitalis toxicity include anorexia, weakness, lethargy, blurred vision, and disorientation. An inability to relax and photosensitivity are not associated with digitalis toxicity.
A nurse is required to care for a child, age 4 years, who is being digitalized. Which of the following changes in the pulse rate indicates that the nurse should withhold the drug?
- A. Pulse rate less than 70 beats per minute
- B. Pulse rate less than 80 beats per minute
- C. Pulse rate less than 90 beats per minute
- D. Pulse rate more than 100 beats per minute
Correct Answer: A
Rationale: In a child, a pulse rate less than 70 beats per minute indicates toxicity. The nurse should withhold the drug when the pulse rate is less than 70 beats per minute and notify the health care provider. A pulse rate less than 60 or more than 100 beats per minute indicates toxicity in adults. A pulse rate less than 90 beats per minute indicates toxicity in infants.
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.
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.
A client is receiving maintenance therapy with digoxin. The nurse understands that which form would be used? Select all that apply.
- A. Capsule
- B. Injection
- C. Ointment
- D. Patch
- E. Tablet
Correct Answer: A,E
Rationale: Capsules and tablets are used for maintenance therapy, injections are used for rapid digitalization, and digoxin patches and ointment do not exist.