Nokea
In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug?
- A. Potassium level 2.8 mEq/L
- B. Potassium level 4.9 mEq/L
- C. Sodium level 140 mEq/L
- D. Calcium level 10 mg/dL
Correct Answer: A
Rationale: Hypokalemia increases the chance of digitalis toxicity. The other levels listed are incorrect.
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The nurse administering the phosphodiesterase inhibitor milrinone recognizes that this drug will have a positive inotropic effect. Which result reflects this effect?
- A. Increased heart rate
- B. Increased blood vessel dilation
- C. Increased force of cardiac contractions
- D. Increased conduction of electrical impulses across the heart
Correct Answer: C
Rationale: Positive inotropic drugs increase myocardial contractility, thus increasing the force of cardiac contractions. Positive chronotropic drugs increase the heart rate. Positive dromotropic drugs increase the conduction of electrical impulses across the heart. Blood vessel dilation is not affected.
A patient about to receive a morning dose of digoxin has an apical pulse of 50 beats/min. What will the nurse do next?
- A. Administer the dose.
- B. Administer the dose, and notify the prescriber.
- C. Check the radial pulse for 1 full minute.
- D. Withhold the dose, and notify the prescriber.
Correct Answer: D
Rationale: Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. The other options are incorrect.
A patient has a digoxin level of 1.1 ng/mL. Which interpretation by the nurse is correct?
- A. It is below the therapeutic level.
- B. It is within the therapeutic range.
- C. It is above the therapeutic level.
- D. It is at a toxic level.
Correct Answer: B
Rationale: The normal therapeutic drug level of digoxin is between 0.5 and 2 ng/mL. The other options are incorrect.
When administering digoxin immune Fab to a patient with severe digoxin toxicity, the nurse knows that each vial can bind with how much digoxin?
- A. 0.5 mg
- B. 1 mg
- C. 1.5 mg
- D. 2 mg
Correct Answer: A
Rationale: Each vial of digoxin immune Fab (Digifab) can bind approximately 0.5 mg of digoxin, helping to neutralize the drug in cases of severe toxicity.
A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab. The patient asks the nurse why the medication is ordered. What is the nurse's best response?
- A. It will increase your heart rate.
- B. This drug helps to lower your potassium levels.
- C. It causes your heart to beat at a slower rate.
- D. This drug is an antidote to digoxin and will help your heart to return to normal functioning.
Correct Answer: D
Rationale: Digoxin immune Fab (Digifab) is the antidote for a severe digoxin overdose and is given to reverse the life-threatening cardiotoxic effects. The other options are incorrect.