Nokea
A nursing instructor is conducting a class on heart failure and the events that occur. The instructor describes which of the following as a result of increases in neurohormonal activity that occur with heart failure? Select all that apply.
- A. Decreased secretion of catecholamines
- B. Remodeling of the cardiac muscle cells
- C. Hypertrophy of the heart
- D. Increased need for oxygen
- E. Cardiac necrosis
Correct Answer: B,C,D,E
Rationale: Increased catecholamines lead to increases in neurohormonal activity that cause remodeling of the cardiac muscle cells, leading to hypertrophy of the heart, increased need for oxygen, and cardiac necrosis, which worsen the heart failure.
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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.
The nurse should educate the client to avoid which of the following nonprescription medications without permission from the physician, as they can interfere with the action of cardiotonic drugs? Select all that apply.
- A. Antacids
- B. Antidiarrheals
- C. Topical arthritis treatments
- D. Artificial tear products
- E. Allergy products
Correct Answer: A,B,E
Rationale: The nurse should teach the client to avoid antacids and nonprescription cough, cold, allergy, antidiarrheal, and diet drugs unless their use has been approved by the physician, as some of these drugs interfere with the action of cardiotonic drugs or cause other potentially serious problems.
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.
A client is prescribed a cardiotonic medication. Which of the following preadministration assessments should the nurse perform on this client?
- A. Inspect joints for swelling.
- B. Check for jugular vein distention.
- C. Inspect skin for rash.
- D. Obtain blood glucose levels.
Correct Answer: B
Rationale: The nurse should check for jugular vein distention as part of the preadministration assessment for the client prescribed a cardiotonic. The nurse need not inspect joints for swelling, inspect skin for rash, or obtain blood glucose levels as these interventions will not provide necessary information with regard to administration of a cardiotonic.
A client is prescribed a cardiotonic drug. The nurse would expect to administer which of the following in conjunction with this drug as part of the treatment for heart failure? Select all that apply.
- A. Loop diuretics
- B. Angiotensin-converting enzyme inhibitors (ACEIs)
- C. Thrazide diuretics
- D. Calcium channel blockers
- E. Beta blockers
Correct Answer: A,B,E
Rationale: Cardiotonic drugs are used in clients with persistent symptoms, with recurrent hospitalization, or as indicated in conjunction with ACEIs, loop diuretics, and beta blockers in clients with heart failure.