Nokea
A patient with heart failure is prescribed digoxin. Which electrolyte imbalance increases the risk of digoxin toxicity?
- A. Hyperkalemia
- B. Hypernatremia
- C. Hypokalemia
- D. Hyponatremia
Correct Answer: C
Rationale: Hypokalemia (low levels of potassium) increases the risk of digoxin toxicity. This is because digoxin competes with potassium for binding sites on the sodium-potassium ATPase pump in the cell membrane. When potassium levels are low, there is an increased binding of digoxin to these pumps, leading to enhanced entry of calcium into the cells. This can result in an increased intracellular calcium concentration, leading to digoxin toxicity and potential cardiac arrhythmias. Therefore, monitoring and correcting potassium levels is crucial in patients prescribed digoxin to reduce the risk of toxicity.
You may also like to solve these questions
As a nurse, which of the following are the critical factors for successful integration of loss during the grieving process?
- A. The patient 's predictable and steady movement form one stage of the process to the next
- B. Accurate assessment and intervention by the nurse or helping person
- C. The nurse trustworthiness and healthy attitude about grief
- D. The patient's adequate perception, adequate support, and adequate coping
Correct Answer: B
Rationale: Accurate assessment and intervention by the nurse or helping person are critical factors for successful integration of loss during the grieving process. This involves the nurse's ability to assess the patient's grieving process effectively, identify their needs, provide appropriate support, and intervene when necessary. By utilizing proper assessment techniques and offering timely interventions, the nurse helps facilitate the patient's journey through the grieving process, promoting healthy coping mechanisms and ultimately assisting in achieving successful integration of their loss. Trustworthiness and a healthy attitude about grief are important qualities for a nurse, but without accurate assessment and intervention, the grieving process may not progress smoothly.
There are pre operative medications given to the patient. Which of the following drugs are given in order to decrease intra-operative anesthetic requirements and pain?
- A. Celebrex (celecoxib)
- B. Acetaminophen (tylenol)
- C. Ibuprofen (motrin)
- D. Demerol (Meperidine HC
Correct Answer: D
Rationale: Demerol (meperidine hydrochloride) is an opioid analgesic commonly used as a preoperative medication to decrease intra-operative anesthetic requirements and provide analgesia. Opioids like Demerol act on the central nervous system to reduce pain sensations, making it an effective choice for preoperative pain management. This can help decrease the amount of anesthesia needed during surgery, leading to better pain control and overall patient comfort during and after the procedure. Celebrex, acetaminophen, and ibuprofen are also used for pain management, but they do not have the same potency and mechanism of action as opioids like Demerol for reducing intra-operative anesthetic requirements.
Whose responsibility is it to obtain informed consent?
- A. Nurse Manager
- B. Physician
- C. Anesthesiologist
- D. Midwife
Correct Answer: B
Rationale: Obtaining informed consent is primarily the responsibility of the physician. Informed consent is a crucial ethical and legal concept in healthcare that requires the healthcare provider, usually the physician, to ensure that the patient understands the proposed treatment, including the risks, benefits, alternatives, and potential outcomes, before agreeing to proceed with the treatment. While other healthcare professionals, such as nurses, nurse managers, anesthesiologists, and midwives, may also play a role in the informed consent process by providing information and clarifying details, it is ultimately the physician who must obtain the patient's informed consent before any treatment or procedure is performed.
A patient in the ICU develops acute myocardial infarction (MI) with cardiogenic shock. What intervention should the healthcare team prioritize to manage the patient's shock?
- A. Perform emergent percutaneous coronary intervention (PCI).
- B. Administer inotropic medications to improve cardiac contractility.
- C. Initiate therapeutic hypothermia to reduce myocardial oxygen demand.
- D. Recommend anticoagulant therapy to prevent thromboembolism.
Correct Answer: A
Rationale: In a patient with acute myocardial infarction (MI) complicated by cardiogenic shock, the primary intervention to manage shock is emergent percutaneous coronary intervention (PCI). PCI is a procedure performed to restore blood flow in an occluded coronary artery that is causing the MI. By opening up the blocked artery and restoring blood flow to the heart muscle, PCI can help reduce myocardial damage, improve cardiac function, and stabilize the patient's condition. Prompt reperfusion via PCI is crucial in the setting of cardiogenic shock to improve survival outcomes and reduce the risk of further complications. Administering inotropic medications, initiating therapeutic hypothermia, or recommending anticoagulant therapy may be components of management in specific cases but are not the primary intervention for managing shock in a patient with acute MI and cardiogenic shock.
During the immediate post-operative phase , the PRIMARY goal of the health care team is to maintain ventilation. Which of the following situations should be observed as a result of hypoxemia?
- A. Excess carbon dioxide in the blood
- B. Increasing ammonia in the blood
- C. Decreased oxygen saturation
- D. Reduction of blood Ph
Correct Answer: C
Rationale: One of the main consequences of hypoxemia, which is low oxygen levels in the blood, is decreased oxygen saturation. Oxygen saturation refers to the percentage of hemoglobin molecules in the blood that are bound to oxygen. When there is insufficient oxygen in the blood due to hypoxemia, the oxygen saturation levels will drop. This can lead to symptoms such as shortness of breath, confusion, rapid heart rate, and ultimately can result in tissue damage if not corrected promptly. Monitoring oxygen saturation levels is crucial in the immediate post-operative phase to ensure adequate ventilation and oxygenation for the patient's recovery.