Nokea
A nurse is preparing to administer a cardiotonic drug via IM injection based on the understanding of which of the following about this route? Select all that apply.
- A. Appropriate when IV access is not available
- B. Site massage necessary after injection
- C. Not the recommended parenteral route
- D. Amount given no more than 2 \mathrm{~mL}
- E. Injection deep into the muscle
Correct Answer: A,B,D,E
Rationale: IM injection is not recommended for cardiotonic drugs yet, but they may be given as an IM injection when needed urgently and no IV access is available. When administering a cardiotonic drug IM, the nurse should give the injection deep in the muscle and follow with massage to the site. No more than 2 \mathrm{~mL} should be injected IM.
You may also like to solve these questions
After teaching a group of nursing students about digoxin, the instructor determines that the teaching was successful when the students identify which of the following as true regarding the monitoring of plasma digoxin levels? Select all that apply.
- A. Levels should be drawn immediately after the dose.
- B. Levels should be drawn immediately before the next dose.
- C. Levels should be drawn 6 to 8 hours after the last dose.
- D. Levels of greater than 2 ng/ml are considered toxic.
- E. Levels are considered therapeutic between 0.5 and 1.5 ng/ml.
Correct Answer: B,C,D
Rationale: Digoxin blood plasma level measurements should be drawn immediately before the next dose or 6 to 8 hours after the last dose regardless of route. Therapeutic digoxin levels are between 0.8 and 2 ng/ml. Plasma digoxin levels greater than 2 ng/ml are considered toxic and are reported to the physician.
To help control the nausea and anorexia that may occur as an adverse reaction during digoxin therapy, the nurse should recommend which of the following? Select all that apply.
- A. Eating frequent smaller meals
- B. Restricting fluids at mealtime
- C. Maintaining good oral hygiene
- D. Eating more protein
- E. Avoiding fluid intake 1 hour before and after meals
Correct Answer: A,B,C,E
Rationale: If the nausea or anorexia is not a result of toxicity but an adverse reaction to the drug, use nursing measures to help control the reactions. Offer frequent small meals rather than three large meals. Restricting fluids at meals and avoiding fluids 1 hour before and after meals help to control nausea. Helping the patient to maintain good oral hygiene by brushing teeth or rinsing the mouth after ingesting food will also help with nausea.
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).
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.
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.