Cardiac MED

A client taking an aldosterone antagonist known as eplerenone for hypertension asks about side effects of this medication. The nurse tells the client that which sign/symptom is a side effect?

Elevated potassium level

The nurse is planning to administer hydrochlorothiazide to a client. Which are concerns related to the administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

A client with chronic atrial fibrillation is being started on maintenance therapy with atenolol for dysrhythmia suppression. The nurse determines that the client needs further teaching about this medication when making which statement?

I can stop taking the prescribed digoxin after starting this new medication."

A client is being discharged with a prescription for propranolol. When reinforcing instructions to the client about the medication, the nurse would include which information?

Medication should be withheld if the pulse rate drops below 60 beats per minute.

A client is diagnosed with an acute myocardial infarction and is receiving tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?

Monitor for signs of bleeding

A client is being treated for acute heart failure with intravenously administered bumetanide. The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96 beats per minute; and respirations, 24 breaths per minute. After the initial dose, which is the priority assessment?

Monitoring blood pressure

The nurse is discharging a client from the hospital who was given a prescription for atorvastatin. The nurse would tell the client to report which adverse effect to the primary health care provider immediately?

Muscle pain and weakness

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The licensed practical nurse (LPN) is concerned that the client received a bolus of medication when the tubing was removed from the IV pump during a gown change. The LPN immediately notifies the registered nurse or primary health care provider and then checks to see whether which medication is available in the medication supply area in case it is prescribed?

Protamine sulfate

A client who takes a diuretic every evening expresses frustration with the medication and wants to stop therapy. When the nurse explores the reasoning, the client says, "It keeps me up all night. I feel as though I should bring my pillow into the bathroom!" Which action can the nurse suggest to assist the client in successfully adapting to this therapy?

Switching to a morning administration of the medication

Isosorbide mononitrate is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic headache. Which action would the nurse suggest to the client?

Take the medication with food.

The nurse is monitoring a client who is taking propranolol. Which data collection finding would indicate a potential serious complication associated with propranolol?

The development of audible expiratory wheezes

The nurse is scheduled to administer a dose of digoxin to a client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. Which would be the nurse's next action?

The dose should be administered as prescribed.

The nurse is reviewing the postoperative prescriptions for a client who has just returned from surgery and notes that the surgeon has prescribed lepirudin. Which is this medication prescribed to prevent?

Thromboembolic complications

A client who is taking hydrochlorothiazide has also been prescribed triamterene. The client asks the nurse why both medications are required. Which response is the most accurate to give to the client?

Triamterene is a potassium-retaining (sparing) diuretic, whereas hydrochlorothiazide is a potassium-excreting diuretic.

The nurse has completed client teaching about heart failure and prescribed medications that include digoxin and furosemide. The nurse documents that the teaching goals have been met if the client states knowing to report which symptom?

Weight gain of 2 to 3 pounds in a few days

The nurse is caring for a client who is taking metoprolol. The nurse measures the client's blood pressure (BP) and apical pulse immediately before administration. The client's BP is 122/78 mm Hg and the apical pulse is 58 beats per minute. Based on this data, which is the appropriate action?

Withhold the medication

A primary health care provider (PHCP) writes a prescription for digoxin, 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to do which?

Withhold the medication and call the PHCP if the pulse is less than 60 beats per minute.

A client is taking ticlopidine hydrochloride. The nurse tells the client to avoid which substance while taking this medication?

acetylsalicylic acid

The nurse is caring for a client receiving digoxin. The nurse monitors the client for which early manifestation of digoxin toxicity?

anorexia

The nurse is reinforcing dietary instructions to a client who is taking triamterene. The nurse instructs the client that it is acceptable to consume which food item daily?

apple

A client with a history of hypertension has been prescribed triamterene. The nurse determines that the client understands the effect of this medication on the diet if the client states to avoid which fruit?

bananas

A client has been given a prescription for gemfibrozil. The nurse plans to instruct the client to limit intake of which food while taking this medication?

beef

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is most important for the nurse to check before administering a second dose of the medication?

blood pressure

The nurse is caring for a client who is receiving hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameters?

blood pressure

The nurse is reinforcing dietary instructions to a client who is taking spironolactone. The nurse instructs the client to avoid which food in the daily diet?

citrus fruits

A client arrives at the health care clinic for follow-up care and evaluation of the effectiveness of prazosin. Which finding indicates a therapeutic effect related to the use of this medication?

decrease blood pressure

Clients who are given a prescription for sildenafil should be taught that a potentially fatal medication interaction can occur with which medication?

nitroglycerin

The nurse provides medication instructions to an older hypertensive client who is taking 20 mg of lisinopril orally daily. The nurse evaluates the need for further teaching when the client makes which statement?

"I can skip a dose once a week."

A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client is seen by the primary health care provider, and Prinzmetal's angina is diagnosed. The nurse is instructing the client about diltiazem. Which client statement indicates a need for further teaching?

"I have to limit my coffee, but I can drink all the fruit juice I want."

The nurse has reinforced instructions to a client receiving enalapril maleate. Which statement by the client indicates a need for further teaching?

"I need to notify the health care provider if nausea occurs."

A client with chronic atrial fibrillation is being started on amiodarone as maintenance therapy for dysrhythmia suppression. The nurse reinforces instructions to the client about the medication. Which statement by the client indicates a need for further teaching?

"I will stop taking the prescribed anticoagulant after starting this new medication."

The nurse reinforces discharge instructions to a postoperative client who is taking warfarin sodium. Which statement made by the client reflects the need for further teaching?

"I will take enteric-coated aspirin for my headaches because it is coated."

The client has been prescribed nifedipine. The nurse is instructing the client about nifedipine. Which client statement indicates a need for further teaching?

"If I see empty tab shells in my stool, I need to report it to my doctor."

A client is experiencing impotence after taking an antihypertensive medication. The client states, "I would sooner have a stroke than keep living with the side effects of this medication." The nurse would make which appropriate response to the client?

"You are concerned about the side effects of your medication?"

A pediatric client with a ventricular septal defect repair is placed on a maintenance dose of digoxin. The safe dose is 0.03 mg/kg/day, and the client's weight is 7.2 kg. The primary health care provider (PHCP) prescribes the digoxin to be given twice daily. How much digoxin would the nurse administer to the client at each dose?

0.1 mg

The nurse is reviewing laboratory results of a digoxin level for the client taking digoxin. The digoxin level is 2.5 ng/mL, which indicates digoxin toxicity. Which signs and symptoms would the nurse note? Select all that apply.

1) Nausea 2) syncope 4) Bradycardia

The nurse is caring for a client who has been prescribed furosemide and is monitoring for adverse effects associated with this medication. Which would the nurse recognize as potential adverse effects? Select all that apply.

2) Tinnitus 3) Hypotension 4) Hypokalemia

A hospitalized client with coronary artery disease complains of substernal chest pain. After checking the client's heart rate and blood pressure, the nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes, the client states, "My chest still hurts." Which appropriate actions would the nurse take? Select all that apply.

3) Check the client's pain level 4) check the client's blood pressure 5) administer a second nitroglycerin, 0.4mg, sublingually

The nurse is reinforcing discharge teaching to a client who was given a prescription for nifedipine for blood pressure management. Which instructions would the nurse reinforce? Select all that apply.

3) Take pulse rate daily 4) weigh at the same time each Day 5) palpating may occur early in therapy 6) be careful when rising from sitting to standing

Warfarin sodium has been prescribed for a client, and the nurse teaches the client and family about the medication. Which statement by the client indicates a need for further teaching?

3. "I will not take any over-the-counter medications except aspirin."

The nurse is monitoring a client receiving furosemide 40 mg orally daily. Which indicator would inform the nurse that a therapeutic effect has occurred?

A blood pressure of 128/80 mm Hg

The nurse is monitoring a client receiving spironolactone by mouth daily. Which data would indicate to the nurse that the client is experiencing a side effect related to the medication?

A potassium level of 5.2 mEq/L

A client is scheduled to receive digoxin 0.125 mg by mouth. The licensed practical nurse (LPN) reads the medication label and notes that each tablet contains 0.25 mg. The LPN would perform which action?

Administer half of a medication tablet.

A client is at risk for pulmonary embolism and is on anticoagulant therapy with warfarin sodium. The nurse is told that the client's prothrombin time is 18 seconds with a control of 11 seconds. Which action would the nurse plan?

Administer the next dose of warfarin sodium.

The nurse is preparing to administer digoxin to an adult client. The nurse checks which important item before administering the medication?

Apical pulse rate

A client is being treated for heart failure and is receiving digoxin. The client's vital signs are blood pressure 85/50 mm Hg, pulse 96 beats per minute, and respirations 26 breaths per minute. To evaluate therapeutic effectiveness of this medication, the nurse would expect which change in the client's vital signs?

Blood pressure 98/60 mm Hg, pulse 80 beats per minute, respirations 24 breaths per minute

The nurse is planning to administer amlodipine to a client. The nurse would plan to check which before giving the medication?

Blood pressure and heart rate

The nurse is assisting in monitoring a client who received hydralazine hydrochloride to treat autonomic dysreflexia. Which finding accurately indicates that the medication is effective?

Blood pressure declines.

Atenolol hydrochloride is prescribed for a hospitalized client. The nurse would perform which as a priority action before administering the medication?

Check the client's blood pressure.

A client with heart failure who is taking furosemide and digoxin calls the nurse and complains of anorexia and nausea. The nurse would take which action?

Check the result of the potassium level drawn 3 hours ago.