Nokea
When caring for a client who has been digitalized for his heart failure, the nurse observes that the client is experiencing bradycardia. Which of the following would the nurse expect the primary health care provider to prescribe for the client's bradycardia?
- A. Atropine
- B. Cholestyramine
- C. Furosemide
- D. Milrinone
Correct Answer: A
Rationale: Atropine should be administered to clients who develop bradycardia. Bradycardia may be seen in digitalis toxicity. Milrinone is a miscellaneous inotropic used in heart failure. Furosemide is a loop diuretic that can be used as part of the drug therapy regimen for heart failure. Cholestyramine is used to lower blood cholesterol levels. Milrinone, furosemide, and cholestyramine are not used in the treatment of bradycardia.
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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.
A client receives his prescribed daily digoxin at 9 a.m. today. The nurse would expect to obtain a serum drug level at which time?
- A. 12 noon today
- B. 4 p.m. today
- C. 9 p.m. tonight
- D. 12 midnight
Correct Answer: B
Rationale: Blood for plasma level measurements should be drawn immediately before the next dose or 6 to 8 hours after the last dose regardless of route. For this client, that would be between 3 p.m. and 5 p.m. today or immediately before his dose tomorrow.
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.
The nurse is caring for a client receiving a cardiotonic drug. The client has edema. Which assessment would be most important?
- A. Auscultation of bowel sounds
- B. Measurement of intake and output
- C. Observation of respiratory rate
- D. Observation of pulse rate
Correct Answer: B
Rationale: Measurement of intake and output would be most important for the client with edema who is receiving a cardiotonic drug. Auscultation of bowel sounds, observation of respiratory rate, and observation of pulse rate are interventions not related to edema in the client.
A nurse would administer the prescribed digoxin (Lanoxin) cautiously for a client with which electrolyte imbalances? Select all that apply.
- A. Hypokalemia
- B. Hypermagnesemia
- C. Hypocalcemia
- D. Hyperkalemia
- E. Hypomagnesemia
Correct Answer: A,C,E
Rationale: The cardiotonic drugs are given cautiously to clients with electrolyte imbalances (especially hypokalemia, hypocalcemia, and hypomagnesemia).