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The nurse is educating an 80-year-old patient diagnosed with HF about his medication regimen. What should the nurse to teach this patient about the use of oral diuretics?
- A. Avoid drinking fluids for 2 hours after taking the diuretic
- B. Take the diuretic in the morning to avoid interfering with sleep
- C. Avoid taking the medication within 2 hours consuming dairy products
- D. Take the diuretic only on days when experiencing shortness of breath
Correct Answer: B
Rationale: Oral diuretics should be administered early in the morning so that diuresis does not interfere with the patients nighttime rest. Discussing the timing of medication administration is especially important for elderly patients who may have urinary urgency or incontinence. The nurse would not teach the patient about the timing of fluid intake. Fluid intake does not need to be adjusted and dairy products are not contraindicated.
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The nurse is caring for a 68-year-old patient the nurse suspects has digoxin toxicity. In addition to physical assessment, the nurse should collect what assessment datum?
- A. Skin turgor
- B. Potassium level
- C. White blood cell count
- D. Peripheral pulses
Correct Answer: B
Rationale: The serum potassium level is monitored because the effect of digoxin is enhanced in the presence of hypokalemia and digoxin toxicity may occur. Skin turgor, white cell levels, and peripheral pulses are not normally affected in cases of digitalis toxicity.
The nurse is reviewing the medication administration record of a patient diagnosed with systolic HF. What medication should the nurse anticipate administering to this patient?
- A. A beta-adrenergic blocker
- B. An antiplatelet aggregator
- C. A calcium channel blocker
- D. A nonsteroidal anti-inflammatory drug (NSAID)
Correct Answer: A
Rationale: Several medications are routinely prescribed for systolic HF, including ACE inhibitors, beta-blockers, diuretics, and digitalis. Calcium channel blockers, antiplatelet aggregators, and NSAIDs are not commonly prescribed.
Cardiopulmonary resuscitation has been initiated on a patient who was found unresponsive. When performing chest compressions, the nurse should do which of the following?
- A. Perform at least 100 chest compressions per minute
- B. Pause to allow a colleague to provide a breath every 10 compressions
- C. Pause chest compressions to allow for vital signs monitoring every 4 to 5 minutes
- D. Perform high-quality chest compressions as rapidly as possible
Correct Answer: A
Rationale: During CPR, the chest is compressed 2 inches at a rate of at least 100 compressions per minute. This rate is the resuscitators goal; the aim is not to give compressions as rapidly as possible. Compressions are not stopped after 10 compressions to allow for a breath or for full vital signs monitoring.
The nurse is caring for an adult patient with HF who is prescribed digoxin. When assessing the patient for adverse effects, the nurse should assess for which of the following signs and symptoms?
- A. Confusion and bradycardia
- B. Uncontrolled diuresis and tachycardia
- C. Numbness and tingling in the extremities
- D. Chest pain and shortness of breath
Correct Answer: A
Rationale: A key concern associated with digitalis therapy is digitalis toxicity. Symptoms include anorexia, nausea, visual disturbances, confusion, and bradycardia. The other listed signs and symptoms are not characteristic of digitalis toxicity.
The nurse is caring for a patient with severe left ventricular dysfunction who has been identified as being at risk for sudden cardiac death. What medical intervention can be performed that may extend the survival of the patient?
- A. Insertion of an implantable cardioverter defibrillator
- B. Insertion of an implantable pacemaker
- C. Administration of a calcium channel blocker
- D. Administration of a beta-blocker
Correct Answer: A
Rationale: In patients with severe left ventricular dysfunction and the possibility of life-threatening dysrhythmias, placement of an implantable cardioverter defibrillator (ICD) can prevent sudden cardiac death and extend survival. A pacemaker, a calcium channel blocker, and a beta-blocker are not medical interventions that may extend the survival of the patient with left ventricular dysfunction.