Cardiovascular

The home care nurse instructs a client on how to administer enoxaparin subcutaneously. Which statement, if made by the client, indicates an understanding of how to administer this medication?

"A syringe that has a small 5/8 in (1.5 cm) needle is used to administer the injection."

A client is admitted to the emergency department with a diagnosis of myocardial infarction (MI). The primary health care provider (PHCP) prescribes the administration of alteplase. The registered nurse (RN) preceptor is orienting a new RN in the use of this medication. Which statement by the new RN indicates that teaching has been effective?

"Administer the medication within 4 to 6 hours after onset of chest pain."

The nurse provides instructions to a client who has a prescription for ticlopidine. Which statement made by the client indicates a need for further teaching?

"Food will affect the medication, so I need to take the medication on an empty stomach."

A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates?

"Have a 12-hour 'no-nitrate' time."

The nurse is providing education to a client who is being started on atenolol. Which statement by the client indicates that teaching has been effective?

"I am taking this medication for hypertension."

The nurse has completed giving medication instructions to a client receiving benazepril. Which client statement indicates to the nurse that the client needs further instruction?

"I can use salt substitutes freely and eat foods high in potassium."

A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement?

"I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed."

A hypertensive client has been prescribed clonidine hydrochloride, a transdermal patch. The nurse provides written instructions to the client on the use of the patch. Which statement by the client indicates the need for further instruction?

"I need to change the patch every 24 hours."

The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN (as needed) use if chest pain occurs. Which client statement indicates an understanding of this medication?

"I need to discard unused tablets 6 months after the bottle is opened."

The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction?

"I need to drink at least 4 quarts (4 liters) of water daily."

A home health care nurse is visiting an older client at home. Furosemide is prescribed for the client, and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching?

"I need to drink lots of coffee and tea to keep myself healthy."

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

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

A client is to be discharged from the hospital on quinidine gluconate to control ventricular ectopy. The nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction?

"I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs."

Minoxidil is prescribed for a client to treat hair loss. The nurse provides instructions to the client regarding the application of the medication. Which statement by the client indicates that teaching is effective?

"I will apply the prescribed amount of solution twice a day."

A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. Adequate learning would be evident if the client makes which statements? Select all that apply.

"I will inform my dentist that I am taking this medication." "I will have my blood levels checked as prescribed by my primary health care provider (PHCP)." "I will report any signs of blood in my urine or stool to my primary health care provider (PHCP)."

The nurse is caring for a child with heart failure (HF). The nurse provides instructions to the mother regarding the procedure for administration of the prescribed digoxin. Which statement by the mother indicates a need for further teaching?

"I will make sure to mix the medication with food."

A client with chronic atrial fibrillation is being started on quinidine sulfate as maintenance therapy for dysrhythmia suppression, and the nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction?

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

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

"I will take coated aspirin for my headaches because it will coat my stomach."

The nurse provides discharge instructions to a client with atrial fibrillation who is taking warfarin sodium. Which statement, by the client, reflects the need for further teaching?

"I will take coated aspirin for my headaches because it will coat my stomach."

Atorvastatin has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching?

"I won't need to adhere to a low-fat diet as long as I take this medication faithfully."

The home health care nurse is visiting a client with coronary artery disease with elevated triglyceride levels and a serum cholesterol level of 398 mmol/L). The client is taking cholestyramine, and the nurse teaches the client about the medication. Which statement by the client indicates the need for further teaching?

"I'll continue my nicotinic acid from the health food store."

The home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking cholestyramine, and the nurse teaches the client about the medication. Which statement, by the client, indicates the need for further teaching?

"I'll continue my nicotinic acid from the health food store."

A neurologist prescribed ticlopidine to the client with thrombotic stroke. The nurse provides instructions to the client and spouse regarding the medication. Which statement made by the client indicates that education was effective?

"I'll take the medicine with meals."

A client is prescribed nicotinic acid for hyperlipidemia, and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions?

"Ibuprofen IB taken 30 minutes before the nicotinic acid should decrease the flushing."

The nurse provides instructions to the client about nicotinic acid prescribed for hyperlipidemia. Which statement by the client indicates understanding of the instructions?

"Ibuprofen taken 30 minutes before the nicotinic acid may decrease the flushing."

Atenolol has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching?

"If I feel that my heart rate is too low, I should stop the medication."

The home care nurse has given instructions to a client who is beginning therapy with digoxin for atrial fibrillation. The nurse determines a need for further teaching if the client makes which statement?

"If I miss a dose, I should just take 2 the next day."

A client is being discharged on warfarin sodium, and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates to the nurse that the client understands the teaching provided?

"If I notice blood-tinged urine, I will call the primary health care provider."

Daily administration of dipyridamole has been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions?

"If I take this medicine with my warfarin, it will protect my artificial heart valve."

Atorvastatin has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond?

"It decreases low-density lipoproteins (LDLs)."

A registered nurse (RN) is orienting a new RN on the use of atorvastatin. Which statement by the new RN indicates that the teaching has been effective?

"It is given to clients with hypercholesterolemia."

A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client schedules an appointment with the primary health care provider because of episodes of chest pain, and Prinzmetal's angina is diagnosed. The client asks the nurse which therapeutic effects the medication will provide, and the nurse provides education. Which statement by the client indicates that the teaching has been effective?

"It prevents an influx of calcium ions in the smooth muscle."

The nurse has provided instructions to a client who will receive alteplase for the treatment of acute myocardial infarction. The nurse determines that teaching was effective if the client states that the main action of alteplase is what?

"It will dissolve any clots that are obstructing the coronary arteries."

Minoxidil is prescribed for a client to treat hair loss. The client asks the nurse if the hair will continue to grow when the medication is stopped. What is the appropriate nursing response?

"Newly gained hair is lost in 3 to 4 months."

The nurse is reviewing heparin infusion therapy and pertinent laboratory values to monitor with the nursing student. Which statement by the student indicates that teaching has been effective?

"Partial thromboplastin time assesses for therapeutic effect of heparin."

A client receives education regarding self-administration of enoxaparin on discharge to home. The client complains, "I feel as if the primary health care provider is discharging me too soon if I still have to take injections at home." Which response should the nurse make?

"Research shows that it is best for clients to administer this medication at home rather than stay in the hospital."

A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement?

"The medication may need to be changed."

A primary health care provider (PHCP) prescribes warfarin sodium for a client. The home care nurse visits the client at home and teaches the client about the medication and its administration. Which statement by the client indicates a need for further teaching?

"The urine normally changes to orange."

The nurse has given the client with atrial fibrillation instructions to take 1 aspirin daily. The client says to the nurse, "Why do I need to take this? I don't get any pain with my heart rhythm. "Which response by the nurse is the most appropriate?

"This will help prevent clot formation in your heart as a result of your heart's rhythm."

A client scheduled to take a subcutaneous anticoagulant at home says to the nurse, "I'm not sure I will be able to take this medication at home." Which statement by the nurse is appropriate?

"What are your concerns about taking this medication at home?"

A client is experiencing impotence after taking guanfacine. The client states, "I would sooner have a stroke than keep living with the effects of this medication." What is the most appropriate response by the nurse?

"You are concerned about the effects of your medication."

A client with nausea and bradycardia is admitted to a medical unit. The family hands the nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin. A family member states, "That primary health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse?

"You are concerned your loved one receives the best care."

A client is admitted to the hospital emergency department with an acute anterior wall myocardial infarction. The nurse discusses thrombolytic therapy with the client and spouse. The spouse is concerned about the dangers of this treatment. Which statement by the nurse is appropriate?

"You have concerns about whether this treatment is the best option."

The nurse is providing discharge instructions to a client taking warfarin sodium. Which statement, based on primary health care provider (PHCP) permission, is appropriate to include in client teaching for this medication?

"You need to check with your doctor about what can be taken for headaches."

A client with hypertension has a new prescription for a medication called moexipril. The nurse plans to provide written directions that tell the client to take the medication at which time?

1 hour before meals

A client with a history of heart failure who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and is complaining of anorexia. The primary health care provider prescribes a serum digoxin level to be done. The nurse checks the results and should expect to note which level that is outside of the therapeutic range?

1.0 ng/mL

The nurse is preparing to administer furosemide 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period?

2 minutes

A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3 mmol/L) and reports anorexia. The health care provider prescribes a serum digoxin level to be done. The nurse checks the results and should recognize which level that is outside of the therapeutic range?

2.2 ng/mL (2.8 nmol/L)

The nurse is reviewing the laboratory results for a client who arrives at the health care clinic for follow-up assessment after being diagnosed with atrial fibrillation. The international normalized ratio (INR) is analyzed because the client has been taking warfarin sodium since discharge from the hospital. The nurse determines that the INR range is at an appropriate level if what value is noted on the laboratory report?

2.3

The nurse is monitoring the laboratory test results for a client who is taking warfarin sodium after mechanical heart valve replacement. The nurse should expect the international normalized ratio (INR) for this client to be at what value in order to be therapeutic?

3.0

A client with aldosteronism is being treated with spironolactone. Which finding indicates to the nurse that the medication is effective?

A decrease in aldosterone production

Levothyroxine is prescribed for a client diagnosed with hypothyroidism. The nurse reviews the client's record and notes that the client is presently taking warfarin. The nurse contacts the primary health care provider (PHCP), anticipating that the PHCP will prescribe which medication?

A decreased dosage of warfarin

The nurse is caring for a client with hypertension who is receiving torsemide orally daily. Which laboratory test result would indicate to the nurse that the client may be experiencing a side or adverse effect related to the medication?

A potassium level of 3.1 mEq/L (3.1 mmol/L)

The nurse is reviewing the assessment findings for a client who has been taking spironolactone for treatment of hypertension. Which, if noted in the client's record, would indicate that the client is experiencing an adverse effect related to the medication?

A potassium level of 5.8 mEq/L (5.8 mmol/L)

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

Acetylsalicylic acid

The nurse is caring for a postpartum client with a diagnosis of deep vein thrombosis who is receiving a continuous intravenous infusion of heparin sodium. Review of which laboratory result is the most important by the nurse?

Activated partial thromboplastin time (aPTT)

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The nurse determines that the client is receiving the therapeutic effect based on which results?

Activated partial thromboplastin time of 60 seconds

A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hr. The nurse determines that the client is receiving the therapeutic effect based on which results?

Activated partial thromboplastin time of 60 seconds

A hospitalized client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure remains stable, the nurse should take which action next?

Administer another nitroglycerin tablet.

The nurse has completed medication administration that included a nitroglycerin. Within minutes, the client is complaining of a headache. Which is the priority nursing action at this time?

Administer the prescribed analgesic.

Hydrochlorothiazide has been prescribed for a client with hypertension. The nurse contacts the primary health care provider (PHCP) to verify the prescription if which condition is noted in the assessment data?

Allergy to sulfonamides

A client with a subarachnoid hemorrhage needs to have surgery delayed until a stable clinical condition is achieved. The nurse prepares to administer which medication as prescribed to prevent clot breakdown and dissolution?

Aminocaproic acid

The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril shortly before the time that the cough began. How should the nurse interpret the development of the cough?

An expected although bothersome side effect of therapy

A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition?

An expected medication side effect

Atenolol has been prescribed for a hospitalized client. The nurse should check which item before administering this medication?

Apical heart rate

The primary health care provider (PHCP) writes a prescription for atenolol for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data?

Apical heart rate is 48 beats/min.

A hospitalized client with coronary artery disease complains of substernal chest pain. After assessing 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 actions should the nurse take? Select all that apply.

Assess the client's pain level. Check the client's blood pressure. Administer a second nitroglycerin, 0.4 mg sublingually.

A client who had surgery 3 days earlier is receiving heparin sulfate by subcutaneous injection every 12 hours. In planning for the client's morning care, the priority nursing intervention is which action?

Assist the client to shave using an electric razor.

A client has recently begun medication therapy with propranolol. The long-term care nurse should plan to notify the primary health care provider (PHCP) if which assessment finding is noted?

Audible expiratory wheezes

The nurse is caring for a client with hyperlipidemia who is taking cholestyramine. Which nursing assessment is most significant for this client relative to the medication therapy?

Auscultate bowel sounds.

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first?

Auscultate the client's apical pulse and blood pressure.

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first?

Auscultate the client's apical pulse and obtain a blood pressure.

A client is scheduled to have heparin sodium 5000 units subcutaneously. What is the most appropriate nursing intervention?

Avoid aspirating prior to injecting the medication.

A client in the postpartum care unit who is recovering from disseminated intravascular coagulopathy is to be discharged on low dosages of an anticoagulant medication. In developing home care instructions for this client, the nurse should include which priority safety instruction regarding this medication?

Avoid taking acetylsalicylic acid (aspirin).

A home care nurse is visiting a client who was discharged to home with a prescription for continued administration of enoxaparin subcutaneously. What is the nurse's priority assessment for this client?

Bleeding gums or bruising

A client is scheduled for a dose of ramipril. The nurse should check which measurement before administering the medication?

Blood pressure

The nurse has given a client the prescribed dose of intravenous hydralazine. The nurse evaluates the effectiveness of the medication by monitoring which client parameter?

Blood pressure

The nurse is administering a dose of clonidine to a client. The nurse should ensure that which item is in place before injecting the medication?

Blood pressure cuff

The nurse should report which assessment finding to the primary health care provider (PHCP) before initiating thrombolytic therapy in a client with pulmonary embolism?

Blood pressure of 198/110 mm Hg

A man has developed atrial fibrillation and has been placed on warfarin. The nurse is doing discharge dietary teaching with the client and determines that the client needs additional education if he states that he would choose which food while taking this medication?

Broccoli

A client has developed paroxysmal nocturnal dyspnea. Which medication should the nurse anticipate will be prescribed by the primary health care provider?

Bumetanide

The nurse is administering a dose of a prescribed diuretic to an assigned client. The nurse should monitor the client for hypokalemia as a side effect of therapy if the client has been receiving which medication?

Bumetanide

The nurse prepares to teach a client with subarachnoid hemorrhage about the effects of nimodipine. The nurse plans to explain which information about the type and action of this medication?

Calcium channel blocker that will decrease spasm in cerebral blood vessels

A client who is scheduled to have warfarin sodium therapy has a prothrombin time (PT) of 28 seconds (28 seconds). What is the most appropriate nursing intervention at this time?

Call the primary health care provider (PHCP).

The primary health care provider (PHCP) writes a prescription for atorvastatin for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data?

Carcinoid of the liver

A client having a myocardial infarction is receiving alteplase therapy. Which action should be carried out by the nurse to monitor for the most frequent side/adverse effect?

Check for signs of bleeding.

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

Check the client's blood pressure.

Fenofibrate is prescribed for a client with hyperlipidemia. The nurse reviews the client's medical history for the presence of what condition that contraindicates the use of this medication?

Cirrhosis of the liver

A client with hypertension has begun taking spironolactone. The nurse teaches the client to limit intake of which food?

Citrus fruits

In reviewing the medication records of a group of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia?

Client receiving spironolactone

A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results?

Collaborate with the PHCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed.

A client with valvular heart disease who has a clot in the right atrium is receiving a heparin sodium infusion at 1000 units/hr and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory results are as follows: activated partial thromboplastin time (aPTT), 32 seconds; international normalized ratio (INR), 1.3. The nurse should take which action based on the client's laboratory results?

Collaborate with the PHCP to obtain a prescription to increase the heparin infusion and continue the warfarin sodium as prescribed.

A primary health care provider (PHCP) prescribes quinidine gluconate for a client. The nurse decides to withhold the medication and contact the PHCP if which assessment finding is documented in the client's medical record?

Complete atrioventricular (AV) block

A client taking verapamil has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication?

Constipation

The primary health care provider has prescribed clonidine for a client with hypertension. The nurse should inform the client that which is a side effect of this medication?

Constipation

A client who has begun taking betaxolol demonstrates an effective response to the medication as indicated by which nursing assessment finding?

Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg

A client who began medication therapy with prazosin hydrochloride 1 week earlier arrives at the health care clinic for follow-up evaluation and care. The nurse interprets that the client is experiencing the expected benefit of therapy if which is noted?

Decreased blood pressure

A client is receiving scheduled doses of lovastatin. The nurse determines that the medication is having the intended effect if which is noted?

Decreased cholesterol level

Atenolol has been prescribed for a client with hypertension, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is an occasional side effect of this medication?

Decreased libido

The nurse is monitoring a client with hypertension who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication?

Development of expiratory wheezes

The nurse is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply.

Diarrhea Blurred vision Nausea and vomiting

The nurse is monitoring a client with heart failure who is taking digoxin. Which findings are characteristic of digoxin toxicity? Select all that apply.

Diarrhea Blurred vision Nausea and vomiting

A client with heart disease is taking digoxin and complains of having no appetite and experiencing diarrhea and blurry vision. The nurse notes that the client's serum potassium level is 3.0 mEq/L (3.0 mmol/L). Based on analysis of the data, what might the nurse expect to note when reviewing the digoxin level results?

Digoxin level higher than 0.8 ng/mL

A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). The client is started on alteplase therapy. The nurse determines that teaching has been effective when the client's significant other states that the purpose of the medication is to perform which action?

Dissolve any clots in the coronary arteries.

The nurse has a prescription to give a client a scheduled dose of digoxin. Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity?

Double vision, loss of appetite, and nausea

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should notify the primary health care provider if ongoing nursing assessment reveals which finding?

Ecchymosis

Gemfibrozil is prescribed for a client. Which laboratory finding should alert the nurse to the need to withhold the medication and contact the primary health care provider?

Elevated liver function tests

A postpartum client with deep vein thrombosis is being treated with anticoagulant therapy. The nurse teaches the client that the primary health care provider (PHCP) should be contacted for which noted side and adverse effects? Select all that apply.

Epistaxis Hematuria Ecchymosis

Atorvastatin has been prescribed for a client, and the client asks the nurse about the side and adverse effects of the medication. What should the nurse tell the client is a frequent side effect of this medication?

Headache

The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan has been prescribed for the client. The nurse should suspect that the client has which condition?

Hypertension

The primary health care provider (PHCP) writes a prescription for lisinopril for a hospitalized client with hypertension. The nurse caring for the client determines that the medication has been prescribed to treat which disorder?

Hypertension

A client who is taking chlorothiazide comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side or adverse effect is present?

Hypokalemia

The nurse is planning to administer hydrochlorothiazide to a client diagnosed with hypertension. The nurse should monitor for which adverse effects related to the administration of this medication?

Hypokalemia, hyperglycemia, sulfa allergy

A client admitted to the hospital is taking atenolol. The nurse monitors the client for which sign or symptom of an adverse effect of the medication?

Hypotension

A client has been prescribed pindolol for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance?

Impotence

The nurse is planning discharge teaching for a client started on acetazolamide for a supratentorial lesion. Which information about the primary action of the medication should be included in the client's education?

It decreases cerebrospinal fluid production.

Atorvastatin has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication?

Liver function studies

The nurse has conducted medication instructions with a client receiving lovastatin. Which periodic blood study will be necessary and included in the client's instructions?

Liver function studies

A client with chronic kidney disease (CKD) who is receiving an antihypertensive medication is experiencing frequent hypotensive episodes. The nurse reviews the client's medication record, knowing that which medication would have the greatest tendency to cause hypotension?

Methyldopa

A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and is receiving a tissue plasminogen activator, alteplase. Which action is a priority nursing intervention?

Monitor for signs of bleeding.

The nurse should educate the client receiving pravastatin to immediately report which finding?

Muscle pain

The nurse is caring for a client who was prescribed furosemide. The nurse should monitor the client for damage of which kidney structure?

Nephron

The nurse is reviewing the primary health care provider's (PHCP's) prescriptions for a client recently admitted to the hospital and notes that the PHCP has prescribed ticlopidine therapy. Which finding on the client's record would indicate a need to contact the PHCP before initiating the medication prescription?

Neutropenia

A client with cardiac disease has begun taking propranolol, and the nurse provides information to the client about the medication. The nurse should tell the client to contact the primary health care provider (PHCP) if which symptoms develop?

Night cough and dyspnea

The nurse has been given a medication prescription to administer intravenous (IV) hydralazine. The nurse obtains which priority piece of equipment needed for use during administration of this medication?

Noninvasive blood pressure cuff

The nurse is caring for a client who suddenly starts complaining of palpitations, restlessness, and anxiety. The nurse obtains a stat electrocardiogram (ECG) which shows this rhythm. Refer to figure. The nurse should perform which actions in anticipation of appropriate medication therapy with amiodarone?

Obtain an infusion pump and prepare to administer 150 mg over 10 minutes followed by a maintenance dose.

A client is scheduled to have alteplase. Which item should the nurse obtain to monitor side/adverse effects of the medication therapy?

Occult blood test strips

The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side or adverse effect related to the medication?

Palpitations

The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client?

Peripheral vasoconstriction

The nurse is providing medication information to a client who is beginning medication therapy with enalapril. The nurse should tell the client that which is an anticipated, although unpleasant, side effect of this medication?

Persistent dry cough

A client is seen in the clinic complaining of anorexia and nausea. The primary health care provider (PHCP) suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity?

Photophobia

A client seen in the health care clinic for follow-up care is taking atorvastatin. The nurse should assess the client for which adverse effect of the medication?

Photosensitivity

The nurse is caring for a client who is taking warfarin. The nurse notes the presence of gross hematuria and large areas of bruising on the client's body. The nurse notifies the primary health care provider (PHCP) and ensures that which prescribed medication is available?

Phytonadione (vitamin K)

The nurse is planning to administer furosemide 40 mg by intravenous push (IVP) through an existing intravenous (IV) line. To deliver this medication safely, the nurse should perform which action?

Pinch the IV tubing above the injection port, and inject slowly over 1 to 2 minutes.

The nurse is caring for a client who is receiving heparin sodium intravenously as a continuous infusion. Which laboratory finding requires immediate nursing intervention?

Platelet count of 100,000 mm3 (100 × 109/L)

A client receiving total parenteral nutrition (TPN) has a history of heart failure. The primary health care provider (PHCP) has prescribed furosemide 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect of this medication?

Potassium

The nurse is preparing to administer furosemide to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to check before administering this medication?

Potassium level

A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the primary health care provider (PHCP) if which laboratory test result is noted?

Potassium level of 2.9 mEq/L (2.9 mmol/L)

A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA) by infusion. Which parameter should the nurse determine requires the least frequent assessment to detect complications of therapy with tPA?

Presence of bowel sounds

A client receiving heparin sodium by continuous intravenous (IV) infusion removes the tubing from the pump to change his hospital gown. The nurse is concerned that the client received a bolus of medication. After requesting a prescription for a stat partial thromboplastin time (PTT), the nurse should check for the availability of which medication in the medication cart?

Protamine sulfate

Enoxaparin sodium is prescribed for a client after hip replacement surgery. Which medication should the nurse anticipate to administer in the event of enoxaparin sodium overdose?

Protamine sulfate

Intravenous heparin therapy is prescribed for a client with atrial fibrillation. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit?

Protamine sulfate

Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit?

Protamine sulfate

A client is being discharged to home with enoxaparin for short-term therapy. What should the nurse explain to the family about the medication action?

Reduces the risk of deep vein thrombosis

A client is scheduled to take ticlopidine. The nurse plans to take which action before implementing this medication therapy?

Review the results of the complete blood cell (CBC) count.

Lisinopril has been prescribed for a client with hypertension. What should the nurse instruct the client about this medication?

Rise slowly from a reclining to a sitting position.

Prior to administering a client's daily dose of digoxin to treat heart failure, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL (2.45 mmol/L); serum magnesium, 1.0 mEq/L (0.4 mmol/L); serum potassium, 4.1 mEq/L (4.1 mmol/L); serum creatinine, 0.9 mg/dL (79.5 mcmol/L). Which result should alert the nurse that the client is at risk for digoxin toxicity?

Serum magnesium level

Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL (2.45 mmol/L); serum magnesium, 1.0 mEq/L (0.5 mmol/L); serum potassium, 4.1 mEq/L (4.1 mmol/L); serum creatinine, 0.9 mg/dL (79.5 mcmol/L). Which result should alert the nurse that the client is at risk for digoxin toxicity?

Serum magnesium level

A client is scheduled to receive a daily morning dose of furosemide. Which client laboratory result warrants a call to the primary health care provider (PHCP) prior to the medication administration?

Serum potassium of 2.8 mEq/L (2.8 mmol/L)

Atenolol has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication?

Slows the heart rate

A nurse provides dietary instructions to a client who will be taking warfarin sodium. The nurse should tell the client to avoid which food item?

Spinach

A client has a prescription to receive enoxaparin. The nurse should plan to administer this medication by which route?

Subcutaneous

The nurse is monitoring a client for adverse effects of medications. Which findings are characteristic of adverse effects of hydrochlorothiazide? Select all that apply.

Sulfa allergy Hypokalemia Hyperglycemia Hypercalcemia

The nurse has a prescription to give a first dose of hydrochlorothiazide to an assigned client. The nurse would question the prescription if the client has a history of allergy to which item?

Sulfa medications

A client is on enalapril for the treatment of hypertension. The nurse teaches the client to seek emergent care if which is experienced?

Swelling of the tongue

A client is taking amiloride 10 mg orally daily for hypertension. What medication instruction should the nurse provide to the client?

Take the dose in the morning.

What should the nurse teach a client about an expected outcome of nesiritide administration?

The client will have an increase in urine output.

The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication?

The development of audible expiratory wheezes

The nurse provides instructions to a client about newly prescribed furosemide. Which information should the nurse use to provide instructions in this teaching session?

The medication acts on the loop of Henle in the nephron.

The nurse is reviewing the use of diltiazem for clients with Prinzmetal's variant angina. The nurse should provide information based on which action of the medication?

The medication works by inhibiting calcium movement across cell membranes of cardiac and smooth muscle.

A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication?

Thrombolytics act to dissolve thrombi that have already formed.

The nurse has completed client teaching on use of thrombolytic medications in acute ischemic stroke. The nurse determines that the educational session was effective if the client states that thrombolytics are used for what purpose?

To dissolve clots

The nurse administered intravenous bumetanide to a client being treated for heart failure. Which outcome indicates that the medication has achieved the expected effect?

Urine output increases from 10 mL hourly.

A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates that the medication has achieved the expected effect?

Urine output increases from 10 mL/hour to greater than 50 mL hourly.

The nurse is preparing to administer heparin sodium subcutaneously. Which nursing action is the most appropriate?

Use a 25- to 26-gauge, ⅝-inch (1.5 cm) needle.

The nurse is providing instructions to a client with chronic atrial fibrillation who is being started on quinidine sulfate. The nurse should plan to provide which instruction to the client?

Wear a MedicAlert bracelet.

A client with heart failure is scheduled to be discharged to home with digoxin and furosemide as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect?

Weight gain of 2 to 3 lb in a few days

The nurse is auscultating a 56-year-old adult client's apical heart rate before giving digoxin and notes that the heart rate is 48 beats/minute. Which action should the nurse take?

Withhold the digoxin, and assess for signs of decreased cardiac output and digoxin toxicity.

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 most important to be sure to implement which measure?

Withhold the medication and call the PHCP if the pulse is slower than 60 beats/min.