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Before administering a cardiotonic drug to a client, which of the following would be most important for the nurse to assess? Select all that apply.
- A. Apical-radial pulse rate
- B. Respiratory rate
- C. Urinalysis
- D. Weight measurement
- E. Blood pressure
Correct Answer: A,B,D,E
Rationale: Preadministration physical assessment should include assessment of the apical-radial pulse rate, respiratory rate, weight, and blood pressure to establish a baseline for comparison. Assessing the client's urine is not required.
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A nurse checks the serum digoxin level of a client and finds it to be increased. Which of the following would the nurse identify as possibly associated with this increase?
- A. Colestipol (Colestid)
- B. Verapamil (Calan)
- C. Clarithromycin (Biaxin)
- D. Calcium carbonate (Maalox)
- E. Spironolactone (Aldactone)
Correct Answer: B,C,E
Rationale: Increased serum digoxin levels can occur with verapamil, clarithromycin, and spironolactone. Antacids, such as calcium carbonate, and colestipol cause a decrease in serum digoxin levels.
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.
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 is prescribed droxin IV as a loading dose. The nurse would expect to administer the drug over which time frame?
- A. 30 seconds
- B. 2 minutes
- C. 5 minutes
- D. 30 minutes
Correct Answer: C
Rationale: When a cardiotonic drug is given IV, it is administered slowly (over at least 5 minutes), and the administration site is assessed for redness or infiltration.
Before administering a cardiotonic drug, the nurse would expect which of the following laboratory tests to be completed? Select all that apply.
- A. Liver function tests
- B. Renal function tests
- C. Complete blood count
- D. Electrolyte levels
- E. Blood glucose
Correct Answer: A,B,C,D
Rationale: Liver function tests, renal function tests, complete blood count with the addition of serum electrolytes, and an electrocardiogram complete the lab workup prior to initiating therapy with a cardiotonic drug. It is not necessary to obtain serum blood glucose, but it might appear with other lab work that has been gathered.