Nokea
To help control the nausea and anorexia that may occur as an adverse reaction during digoxin therapy, the nurse should recommend which of the following? Select all that apply.
- A. Eating frequent smaller meals
- B. Restricting fluids at mealtime
- C. Maintaining good oral hygiene
- D. Eating more protein
- E. Avoiding fluid intake 1 hour before and after meals
Correct Answer: A,B,C,E
Rationale: If the nausea or anorexia is not a result of toxicity but an adverse reaction to the drug, use nursing measures to help control the reactions. Offer frequent small meals rather than three large meals. Restricting fluids at meals and avoiding fluids 1 hour before and after meals help to control nausea. Helping the patient to maintain good oral hygiene by brushing teeth or rinsing the mouth after ingesting food will also help with nausea.
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When educating a group of nursing students on the signs of heart failure, the nurse mentions that the ejection fraction is altered in heart failure. The students demonstrate understanding of the information when they identify which ejection fraction as suggesting heart failure?
- A. 38%
- B. 48%
- C. 58%
- D. 68%
Correct Answer: A
Rationale: The ejection fraction is the amount of blood that is ejected from the ventricles per beat in relation to the amount of blood available to eject. An ejection fraction of less than 40% indicates heart failure. Normally the ejection fraction should be greater than 60%.
A nurse is preparing to administer a cardiotonic drug via IM injection based on the understanding of which of the following about this route? Select all that apply.
- A. Appropriate when IV access is not available
- B. Site massage necessary after injection
- C. Not the recommended parenteral route
- D. Amount given no more than 2 \mathrm{~mL}
- E. Injection deep into the muscle
Correct Answer: A,B,D,E
Rationale: IM injection is not recommended for cardiotonic drugs yet, but they may be given as an IM injection when needed urgently and no IV access is available. When administering a cardiotonic drug IM, the nurse should give the injection deep in the muscle and follow with massage to the site. No more than 2 \mathrm{~mL} should be injected IM.
A client is prescribed a cardiotonic medication. Which of the following preadministration assessments should the nurse perform on this client?
- A. Inspect joints for swelling.
- B. Check for jugular vein distention.
- C. Inspect skin for rash.
- D. Obtain blood glucose levels.
Correct Answer: B
Rationale: The nurse should check for jugular vein distention as part of the preadministration assessment for the client prescribed a cardiotonic. The nurse need not inspect joints for swelling, inspect skin for rash, or obtain blood glucose levels as these interventions will not provide necessary information with regard to administration of a cardiotonic.
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.
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.