Pharmacology

Which drug that by blocking receptors for aldosterone (Improve survival)?

Aldactone

Which symptom is a life threatening adverse of digoxin?

Dysrhythmias

An adult male patient has taken medication for management of hypertension for 3 years. He says to the nurse, "I'm not going to take these drugs anymore, because they are interfering with my sex life." Which response by the nurse would be most helpful?

"Let's discuss this effect with your prescriber. There are other drugs available to manage your blood pressure that may not have the same adverse effect." Correct Many antihypertensive medications can produce adverse sexual side effects, including impotence. It is important for the nurse to listen to the patient's concerns and to avoid making value judgments. Other antihypertensive medications may manage this patient's blood pressure without causing adverse sexual effects. Reducing the undesired effects of antihypertensive medication will improve the patient's adherence.

The nurse is caring for a patient with bipolar disorder treated with lithium (Eskalith). The patient has a new prescription for captopril (Capoten) for hypertension. The combination of these two drugs makes which assessment particularly important? Lithium level Correct

ACE inhibitors, such as captopril, can cause lithium accumulation. Lithium levels should be monitored on a regular basis. ACE inhibitors can cause hyperkalemia, renal insufficiency in some patients, and hypotension. However, the combination of lithium and captopril would not increase the risk of these effects.

The nurse is caring for a patient prescribed aliskiren (Tekturna). In which way does this medication act to lower blood pressure? It inhibits the conversion of angiotensinogen into angiotensin I. Correct

Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus inhibits the conversion of angiotensinogen to angiotensin I. The other items describe ACE inhibitors, ARBs, and selective aldosterone receptor blockers.

Which component of the electrocardiogram (ECG) represents the depolarization of the ventricles? QRS complex Correct

An electrocardiogram has several components. The P wave is caused by depolarization in the atria; the QRS complex is caused by depolarization of the ventricles; and the T wave is caused by repolarization of the ventricles. The ST segment may be depressed in some clinical conditions.

Which sustained dysrhythmia is the most common among the U.S. population? Atrial fibrillation Correct

Atrial fibrillation is the most common dysrhythmia, affecting approximately 2.2 million in the United States. This problem not only disrupts cardiac function, but also carries a high risk of embolic stroke.

A patient is prescribed lisinopril (Prinvil) as part of the treatment plan for heart failure. Which finding indicates that the patient is experiencing the therapeutic effect of the drug? Crackles in the lungs are no longer heard Correct

Because ACE inhibitors promote venous dilation, they provide the therapeutic effect of reducing pulmonary congestion and peripheral edema. Absence of previously heard crackles would be an indicator of effectiveness. Edema and jugular vein distention are manifestations of heart failure. A potassium level of 3.5 mEq/L is a normal value.

Which is the only cardiovascular indication for minoxidil (Rogaine)? Severe hypertension Correct

Because of its serious adverse effects, minoxidil is reserved for patients who have failed to respond to safer drugs. The only cardiovascular indication for minoxidil is severe hypertension.

The nurse is preparing to administer a daily dose of digoxin (Lanoxin). Which assessment receives priority at this time? Evaluating for a change in the heart rhythm Correct

Before giving digoxin, the nurse will assess the heart rate and rhythm. The dosage will be held and the prescriber notified if the heart rate is below 60 beats per minute or if the cardiac rhythm has changed. Digoxin can cause bradycardia and electrical changes in the heart.

Initial therapy for hypertension after a myocardial infarction (MI) includes drugs from which classes? Beta blocker and ACE inhibitor Correct

Beta blockers and ACE inhibitors, as well as aldosterone antagonists, are the drug classes recommended for initial therapy of hypertension after an MI. Diuretics and calcium channel blockers are not part of initial therapy for hypertension after an MI.

Calcium channel blockers work by reducing calcium influx into the cells of the heart and blood vessels. Calcium channels are coupled to which type of autonomic nervous system receptors? Beta1 Correct

Calcium channels are coupled to beta1-adrenergic receptors in the heart. For that reason, calcium channel blockers affect the heart in ways similar to the beta blockers. Both types of drugs cause a decrease in the force of contraction, heart rate, and cardiac impulse conduction.

The nurse is working with a group of patients with hypertension. The nurse understands that which agent works by preventing angiotensin II from binding with its receptors? Candesartan (Atacand) Correct

Candesartan is an angiotensin II receptor blocker (ARB) and thus prevents the binding of angiotensin II at its receptor sites. Quinapril is an ACE inhibitor; aliskiren is a direct renin inhibitor, and eplerenone is a selective aldosterone receptor blocker.

RN prepares to administer of digoxin RN finds a laboratory report of a plasma of digoxin level of 0.7. What should the RN do?

Check apical pulse and if in the therapeutic level is good give the medication.

Patient who is taking digoxin 0.25 mg and Furosemide (Lasix) 40mg. Patient states I "see yellow halos of ligths". What should be the RN action?

Check for other signs and symptoms of digitalis toxicity.

The nurse is administering lidocaine (Xylocaine) to a patient with a ventricular dysrhythmia. What action should the nurse take to prevent a complication with this drug? Monitor the ECG Correct

Continuous ECG monitoring is required during lidocaine infusions so that the cardiac response can be evaluated and the dosage adjusted accordingly. Blood counts are not necessary, because lidocaine is not linked to blood dyscrasias. Lidocaine preferably is given intravenously (IV) rather than intramuscularly (IM). Timing with meals is not necessary. Naloxone is a reversal agent for opioids and is not used with lidocaine.

What outcomes should a nurse expect after an administration of digoxin?

Decrease heart rate, slowed cardiac conduction speed and strenghened cardiac contractions

The nurse is caring for a patient who takes quinidine (Quinaglute) for a supraventricular dysrhythmia. What is a common adverse effect of this drug? Diarrhea Correct

Diarrhea and other gastrointestinal problems occur in approximately one-third of patients who take quinidine. This is the most common reason patients stop taking the drug.

RN review blood result of digoxin level of 3mg and K of 6.2. What does the RN expect the MD to prescribe?

Digoxin Immune Fab (digibind)

Which medication is not associated with prolongation of the QT interval? Diltiazem (Cardizem) Correct

Diltiazem does not prolong the QT interval. Dofetilide, sotalol, and dronedarone all prolong the QT interval, putting the patient at risk for torsades de pointes.

The nurse has just administered the initial dose of enalapril (Vasotec) to a newly admitted patient. Which nursing intervention takes priority over the next several hours? Monitoring the blood pressure Correct

Drawing blood for potassium levels First-dose hypotension is a serious potential adverse effect of ACE inhibitors, such as enalapril. Monitoring the blood pressure is the priority nursing intervention. If hypotension develops, the nurse will place the patient in the supine position and possibly increase intravenous fluids.

A patient is receiving dronedarone (Multaq) for treatment of atrial fibrillation. When previous and present ECGs are compared, which change indicates an adverse effect? The QT-interval measurement changes from 400 msec to 520 msec. Correct

Dronedarone prolongs the QT interval by about 10 msec. A QT-interval measurement of 400 msec in a normal heart rate (60 to 100 beats per minute) is normal. Prolongation to 520 msec would increase the risk of torsades de pointes. Newly inverted T waves and ST-segment depression can be signs of ischemia or infarction and warrant further investigation through analysis of troponin levels. Notched P waves can be a sign of valvular heart disease and are unrelated to treatment with dronedarone.

In which situation is dronedarone (Multaq) contraindicated? Concomitant administration of amitriptyline (Elavil) Correct

Drugs and supplements that prolong the QT interval (e.g., phenothiazines, tricyclic antidepressants, amitriptyline, class I and class III antidysrhythmics) can intensify dronedarone-induced QT prolongation, thereby increasing the risk of torsades de pointes. These drugs are contraindicated for use with dronedarone.

The nurse recognizes that nifedipine (procardial) has many side effects. Which side effects should the RN monitor?

Flushing, dizziness, gengival and hyperplasia.

The nurse is caring for patient taking QUINIDINE to suppress sustained ventricular tachycardia. The RN observes that the EKG shows QRS complex . What should the nurse do based on this measures?

Hold the medication and notify provider about the 60% of baseline measurement.

Which laboratory abnormality may be a consequence of therapy with a thiazide diuretic? Serum uric acid level of 10.4 mg/dL Correct

Hyperuricemia is a side effect of thiazide diuretics. Normal uric acid levels typically range from 3.6 to 8.5 mg/dL. Hyperglycemia, not hypoglycemia, and hypokalemia, not hyperkalemia, are side effects of thiazides.

Before administering hydralazine (Apresoline), it is most important for the nurse to obtain which assessment? Blood pressure Correct

Hydralazine is a vasodilator that causes arteriolar dilation, decreased resistance, and decreased blood pressure. Monitoring of the blood pressure and heart rate is the highest assessment priority.

Which medication or medications should be used with caution in a hypertensive diabetic patient? (Select all that apply.) Furosemide (Lasix) Correct Metoprolol (Lopressor) Correct Hydrochlorothiazide (HCTZ) Correct

Hydrochlorothiazide and furosemide promote hyperglycemia, and metoprolol suppresses glycogenolysis and can mask signs of hypoglycemia. Therefore, these medications should be administered with caution to patients with diabetes.

The nurse is caring for a pregnant patient who is experiencing a new episode of hypertension. Which agent does the nurse anticipate will be prescribed for this patient? Methyldopa (Aldomet) Correct

Hypertension is the most common complication of pregnancy, occurring in about 10% of pregnant patients. When drug therapy is initiated during pregnancy, methyldopa is the traditional agent of choice because of its limited effects on the fetus. Patients with pre-existing hypertension typically can continue taking the antihypertensives they previously were prescribed except for angiotensin-converting enzyme (ACE) inhibitors, such as captopril; angiotensin II receptor blockers (ARBs), such as valsartan; and direct renin inhibitors, such as aliskiren.

A patient is admitted to the emergency department in hypertensive crisis, and examination reveals papilledema. The nurse would expect which IV medications to be administered to achieve rapid, controlled reduction of the patient's blood pressure? Sodium nitroprusside (Nitropress) Correct

Hypertensive crisis associated with papilledema, intracranial hemorrhage, myocardial infarction, or acute heart failure is a severe emergency, and the BP must be lowered rapidly (within 1 hour). Intravenous sodium nitroprusside (Nitropress) usually is the drug of choice first used, because its effects begin within seconds of initiation of the continuous IV infusion, and they fade rapidly when the infusion is stopped.

Patient with atrial flutter for 24 hours. What does the RN antecipates that will be given to attempt conversion of sinus rhythm?

Ibutilide

What are the RN front line therapy for treatment of Heart Failure?

It consist of diuretic, ACE inhibition and beta blocker.

The nurse is providing education for patient undergoing therapy with procainamide. What are the possible adverse affect?

Lupus like syndrome

The nurse is caring for several patients. For which patient would a prescription for nifedipine (Adalat) be least appropriate? A 78-year-old man with atrial fibrillation Correct

Nifedipine produces very little blockade of the calcium channels of the heart; therefore, it is ineffective for treating dysrhythmias, such as atrial fibrillation. Therapeutic uses for nifedipine include the treatment of angina pectoris and essential hypertension.

Which medication should the RN expect that will be prescribed for the patient taking digoxin and develops digoxin indulced dysrythmias?

Phenytoin

The nurse is caring for a patient who has diabetes and hypertension. Which agent is most likely to be prescribed to treat this patient's hypertension? Enalapril (Vasotec) Correct

Preferred antihypertensives for patients with diabetes include ACE inhibitors (enalapril), ARBs, and calcium channel blockers. ACE inhibitors are particularly useful, because they slow the progression of diabetic nephropathy in addition to lowering blood pressure. Thiazide diuretics promote hyperglycemia and are used with caution.

The nurse is caring for a patient taking amiodarone for several months. Patient exhibiting dyspnea and coughing and complains of CP. Which condition might the RN suspect?

Pulmonary toxicity

The nurse is caring for a patient receiving amiodarone (Cordarone). Which parameter takes priority when this patient is assessed for serious adverse effects of this drug? Respiratory symptoms Correct

Pulmonary toxicity is the most serious potential adverse effect of amiodarone. It may manifest as pneumonitis or pulmonary fibrosis, with symptoms such as dyspnea, cough, and chest pain.

The nurse is evaluating the teaching done with a patient who has a new prescription for fosinopril (Monopril). Which statement by the patient indicates a need for further teaching? "I will use a salt substitute to lower my sodium intake." Correct

Salt substitutes contain potassium and may increase the risk of hyperkalemia with ACE inhibitors, such as fosinopril. The patient should not take potassium supplements or use salt substitutes. The other statements are appropriate for this patient.

What is the primary benefit of spironolactone (Aldactone) in patients with heart failure? Profound diuresis and fluid loss Blockage of aldosterone receptors Correct

Spironolactone is a potassium-sparing diuretic that has been shown to prolong survival in patients with heart failure. It has only weak diuretic properties. The primary benefit of this drug is blockage of aldosterone receptors.

Patient angiostensin converting enzyme ACE inhibitor. Patient asks if this medication will have a long term affect on his general cardiovascular health. What's the RN best response?

Suppression of angiostension it seems to diminish overtime, but ACE inhibitors also increases kinin release which has favorable effect on cardiac remodeling.

Place in order the correct path of the cardiac conduction system. Purkinje fibers Correct Atrioventricular (AV) node Correct Sinoatrial (SA) node Correct Right and left bundle branches Correct Bundle of His Correct Internodal pathways Correct

The SA node normally initiates the heartbeat. These impulses are transmitted through the heart in a systematic fashion to produce atrial and then ventricular contraction.

Class 1B - Why should the RN expect from class 1B drugs to accelerate repolarization of class?

The class 1 antidysrhythmic drugs block sodium channels.

A patient develops supraventricular tachycardia (SVT) and is hypotensive. The nurse anticipates that which medication will be administered? Adenosine (Adenocard) Correct

The drug of choice for terminating SVT is adenosine. Lidocaine is used for ventricular dysrhythmias; amiodarone is used for atrial and ventricular dysrhythmias; and phenytoin is used for digoxin-induced dysrhythmias.

Which statement by a patient indicates understanding of treatment with doxazosin? "When getting out of bed in the morning, I will sit on the side of the bed for several minutes before standing." Correct

The most disturbing side effect of alpha blockers, such as doxazosin, is orthostatic hypotension, because it can affect the patient's safety. Patients should change positions slowly and carefully. Excessive hair growth is a side effect of minoxidil. Persistent cough is an adverse effect of ACE inhibitors. Hypokalemia is a side effect of thiazide and loop diuretics, so additional sources of potassium should be incorporated into the diet.

What does the nurse understand regarding misisritide therapy?

The nurse understands that of misisritide in treating HF is that it reduces both preload and afterload.

Patient taking hydralazine and a week later patient complain of heart rate going up and down. What might the RN antecipate that the provider will prescribe?

To countercounte this reflex tachycardia RN anticipate that beta blocker will be prescribed.

The nurse is caring for a patient receiving hydralazine (Apresoline). The primary care provider prescribes propranolol (Inderal). The nurse knows that a drug such as propranolol often is combined with hydralazine for what purpose?

To protect against reflex tachycardia Correct Hydralazine is a vasodilator that lowers blood pressure, but it also can trigger reflex tachycardia. Beta blockers, such as propranolol, are added to the regimen to normalize the heart rate.

RN preparing administration of digoxin to treat patient with HF. Which assessment are essential for the nurse to perform?

Use a cardiac monitor during administration of drugs and monitor patient for at least 2 hours afterward.

The nurse is teaching a patient who has just been prescribed a vasodilator. Which statement by the patient indicates that the teaching was effective? "I will rise slowly when changing from a sitting to a standing position." Correct

Vasodilators may cause postural hypotension and reflex tachycardia. Patients should be taught to move slowly when changing positions to prevent dizziness.

The nurse is caring for a patient with heart failure who takes digoxin (Lanoxin). Which finding would require immediate attention by the nurse? Vomiting and diarrhea Correct

Vomiting and diarrhea can lead to hypokalemia, which increases the risk of digoxin toxicity. These symptoms, along with nausea, fatigue, and visual disturbances, also may precede digoxin toxicity and warrant further attention. The heart rate, potassium level, and digoxin level are all within normal range.

What should the nurse monitor for adverse side effects of Carverdilol ?

a) Dizziness

A patient is prescribed Calan SR 120 mg daily. Which statement by the patient indicates understanding of the medication? "I'll need to reduce the amount of fiber in my diet." "I will swallow the pill whole." Correct

"SR" indicates that the drug is sustained release; therefore, the patient must swallow the pill intact, without chewing or crushing, which would result in a bolus effect. Grapefruit juice should be avoided, because it can inhibit intestinal and hepatic metabolism of the drug, thereby raising the drug level. Constipation, not loose stools is a common side effect of Calan; increasing fluids and dietary fiber can help prevent this adverse effect.

A patient in a hypertensive crisis is being started on a continuous sodium nitroprusside (Nipride) infusion. Which activities should the nurse implement? (Select all that apply.) Obtain a baseline weight and weigh daily. Correct Collaborate with the physician on insertion of an arterial line. Correct Cover the IV bottle containing the medication with an opaque bag. Correct

A Nipride infusion is ordered in micrograms/kilogram/minute. Knowing the patient's weight is essential for calculating the appropriate dose. Also, tracking daily weights and comparing them with the baseline values helps the nurse determine whether the adverse effect of fluid retention has developed.

Before amiodarone therapy for atrial fibrillation is initiated, what should take place? Blood should be drawn for baseline serum thyroid and liver function studies. Correct

Amiodarone may cause hypothyroidism or hyperthyroidism and may also injure the liver. Serum thyroid and liver function levels should be assessed before treatment with amiodarone is started and periodically during treatment. Patients who develop changes in visual acuity or peripheral vision while taking amiodarone should have an ophthalmologic evaluation, but this is not necessary before starting therapy. A dermatologic examination and TEE are not necessary before initiation of amiodarone therapy. Although patients with atrial fibrillation are at risk for mural thrombus, amiodarone therapy itself does not pose a risk of systemic embolization.

The heart undergoes cardiac remodeling during the early phase of heart failure. Which finding describes the geometric changes that occur during heart failure? Ventricular wall thickening Correct

An increase in ventricular wall thickness, also called ventricular hypertrophy, is characteristic of the remodeling process during early heart failure. The ventricles also dilate and become more spherical (less cylindric). This change in cardiac shape typically occurs after cardiac injury under the influence of the neurohormonal systems, such as the sympathetic nervous system and renin-angiotensin-aldosterone system.

The renin-angiotensin-aldosterone system plays an important role in maintaining blood pressure. Which compound in this system is most powerful at raising the blood pressure? Angiotensin II Correct

Angiotensin II is a potent vasoconstrictor. It participates in all the pathways regulated by the renin-angiotensin-aldosterone system. Angiotensin I is a precursor to angiotensin II; angiotensin III is formed by degradation of angiotensin II and is less potent. Renin catalyzes the conversion of angiotensinogen to angiotensin I.

A patient with heart failure has a decrease in glomerular filtration rate. Which change in the medication regimem would the RN expect?

CHANGE the order FROM HYDROCHLORITHIAZIDE TO FUROSEMIDE.

The nurse is caring for a patient with cardiac care who is receiving lidocaine. Patient is having convulsion, confession. What should the nurse do?

DIAZEPAN - RN should expect to administer immediately intravenous medication

The nurse is caring for a patient who takes spironolactone (Aldactone) and quinapril (Accupril) for treatment of heart failure. Which symptom, if found, would indicate a potential interaction between these two drugs? Potassium level of 5.7 mEq/L Correct

Both spironolactone, a potassium-sparing diuretic, and quinapril, an angiotensin-converting enzyme (ACE) inhibitor, can increase potassium levels. These agents together do not increase quinapril levels, lower the heart rate, or raise the blood glucose level.

The Seventh Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7 report), released in 2003, is the guiding document for treatment of hypertension in the United States. Which principles are included in these guidelines? (Select all that apply.)

For most patients, thiazide diuretics should be used as the initial medication therapy. Correct Blood pressure should be measured twice at a clinic visit, with the patient seated in a chair with feet on the floor. Correct The diagnosis of hypertension typically is made after several elevated readings at more than one clinic visit. Correct Patients with prehypertension (120 to 139/80 to 89) should adopt lifestyle changes. Medication therapy is not indicated until the blood pressure (BP) is higher than 140 systolic or 90 diastolic. In people older than age 50 years, an elevated systolic BP is more dangerous than an elevated diastolic BP. Thiazide diuretics lower BP by reducing blood volume and arterial resistance. They are considered the initial first-line therapy for most patients. Hypertension generally is diagnosed after repeated elevated measurements. The BP should be measured twice, 5 minutes apart, with the patient seated in a chair with the feet on the floor.

In which area of the healthy heart is the electrical impulse delayed to provide time for the blood to fill the ventricles? AV node Correct

Impulses originate in the SA node and then travel through the AV node to reach the ventricles. The impulse is delayed at the AV node to provide time for the ventricles to fill before they contract.

In the failing heart, arterial pressure falls, stimulating the baroreceptor reflex to increase sympathetic nervous system activity. Which finding is an expected outcome of increased sympathetic activity? Tachycardia Correct

Increased sympathetic activity results in an increased heart rate (tachycardia), increased contractility, increased venous tone, and increased arteriolar tone (elevated blood pressure). Sympathetic stimulation also causes bronchodilation (not bradypnea) and possibly hyperglycemia.

The nurse is caring for a patient receiving a nitroprusside (Nipride) intravenous infusion. The patient's wife asks why furosemide (Lasix) is being prescribed along with this drug. The nurse's response is based on which concept?

Many vasodilators cause retention of sodium and water. Correct Nitroprusside is a potent vasodilator that can cause retention of sodium and water. Furosemide, a diuretic, often is combined with nitroprusside to reduce the risk of edema and fluid retention.

The nurse is planning care for a group of patients with cardiac problems who are at risk for dysrhythmias. The nurse understands that the Cardiac Arrhythmia Suppression Trial (CAST) confirmed which finding? Dysrhythmias should be treated only when they are symptomatically significant. Correct

Most rhythm problems result in bradydysrhythmias. The Cardiac Arrhythmia Suppression Trial (CAST) confirmed that all dysrhythmia drugs have prodysrhythmic effects and can worsen existing dysrhythmias and generate new ones. In this study, patients who received encainide and flecainide to prevent rhythm problems after myocardial infarction actually had higher rates of mortality than the control group.

Which agent is most likely to cause the side effect of constipation? Diltiazem (Cardizem) Correct

Nifedipine, amlodipine, and isradipine, which are dihydropyridine calcium channel blockers, cause less risk of constipation than diltiazem and verapamil.

Which statement is accurate about the effect of lidocaine of the heart?

No affect on the EKG

Discharge teaching about amiodarone should include which statements? (Select all that apply.) "Wear sunblock and protective clothing when you are outdoors." Correct "Check your pulse daily and report excessive slowing to your prescriber immediately." Correct "Report new onset of dyspnea, cough, and chest pain immediately to your prescriber." Correct

Patients frequently experience photosensitivity reactions while taking amiodarone. To reduce this risk, patients should avoid sunlamps and wear sunblock and protective clothing when outdoors. Excessive slowing of the heart rate may indicate that the patient is experiencing sinus bradycardia or an AV block. Dyspnea, cough, and chest pain may indicate pulmonary toxicity. Grapefruit juice should be avoided, because it may increase amiodarone levels and thus the risk of toxicity. Gastrointestinal side effects of amiodarone can be reduced by taking the drug on a full stomach.

Which scenario would warrant an immediate call to the physician by the nurse? A patient who takes oral spironolactone (Aldactone) 25 mg daily and enalapril (Vasotec) 5 mg daily presents with a serum potassium level of 5.5 mEq/L. Correct

Patients who take an aldosterone antagonist (spironolactone) are at risk for developing hyperkalemia. The risk is increased if an aldosterone antagonist and an ACE inhibitor (enalapril) are used together. The optimal range for the serum digoxin level is 0.5 to 0.8 ng/mL. The risk of digoxin toxicity increases when hypokalemia is present (potassium level below 3.5 mEq/L).

The nurse is caring for an adult male with renal artery stenosis who has been prescribed benazepril (Lotensin). Which symptom, if found, indicates an adverse effect of this drug? Serum creatinine level of 2.3 mg/dL Correct

Patients with bilateral renal artery stenosis are at increased risk for renal insufficiency and failure with angiotensin-converting enzyme (ACE) inhibitors, such as benazepril. ACE inhibitors do not typically cause hypokalemia, hyperglycemia, or hyperuricemia.

The nurse is caring for a patient with hypertension who is receiving verapamil (Calan). The patient has a healthy heart. What pharmacodynamic effects does the nurse expect from this drug? (Select all that apply.) Peripheral vasodilation Correct Coronary vasodilation Correct

Verapamil causes peripheral vasodilation and coronary vasodilation, which lead to decreased blood pressure and improved coronary perfusion. It does not cause vasoconstriction and usually has little effect on the heart rate or contractility in healthy hearts.

The nurse is teaching an older adult patient with hypertension who has a new prescription for verapamil (Calan). Which statement or statements by the patient indicate that the teaching was effective? (Select all that apply.) "I will increase my intake of fluid and foods high in fiber." Correct "I will call my physician if I notice swelling in my ankles." Correct

Verapamil often causes constipation and can also cause peripheral edema. Patients should take measures to prevent constipation and should call about new symptoms of peripheral edema. Patients taking verapamil should not experience photosensitivity, hyperkalemia, or increased bruising and bleeding.

1- What should the nurse monitor if the patient is taking Enalapril for Heart Failure?

a)The nurse should monitor for signs and symptoms of hyperkalemia

Which statement by a 50 years old women needs further teaching about Digoxin side effects.

a)This medication prolongs life in women