Nokea
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.
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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.
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.
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.
When reviewing the medical record of a client who is prescribed a cardiotonic, which condition would lead the nurse to contact the primary health care provider because the drug is contraindicated for use? Select all that apply.
- A. Digitalis toxicity
- B. Hypertension
- C. Cardiac tamponade
- D. Hypotension
- E. Ventricular tachycardia
Correct Answer: A,C,E
Rationale: The cardiotonics are contraindicated in the presence of digitalis toxicity and in clients with known drug hypersensitivity, ventricular tachycardia, cardiac tamponade, restrictive cardiomyopathy, or AV block.
A nurse is preparing to administer a prescribed cardiotonic to a client. The nurse understands that the drug is being administered to achieve which of the following? Select all that apply.
- A. Improved myocardial contractility
- B. Increased myocardial efficiency
- C. Increased blood pressure
- D. Increased peripheral edema
- E. Improved profusion to all body tissues
Correct Answer: A,B,E
Rationale: Cardiotonics are drugs used to increase the efficiency and improve the contraction of the heart muscle, which leads to improved blood flow to all tissues of the body.