Perfusion pharmacology

A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor? a. Potassium levels b. Sodium levels c. Electrocardiogram results d. Liver enzymes

a. Potassium levels

A client has an elevated BUN. The client has been prescribed digoxin for heart failure. What aspect of care is the priority regarding this client? a. The dose should be decreased in this client. b. The dosage should be 1.0 mg per mouth daily. c. The dose should be increased when the heart rate is below 60. d. The client should be taught to increase sodium in the diet.

a. The dose should be decreased in this client. The dose must be reduced in the presence of renal failure because most of the digoxin is excreted unchanged by the kidneys, leading to drug accumulation and toxicity. The client should be taught to limit sodium intake in the diet. The client's heart rate should remain above 60. If the heart rate falls below 60, the digoxin should be held. The dose of 1.0 mg is too large for a client with altered renal function.

What is the most accurate method for preventing adverse effects associated with the use of digoxin? a. Teach clients to take their digoxin in divided doses with each meal. b. Assess the client's heart rate and hold administration if it is less than 60. c. Teach clients the signs and symptoms of heart failure. d. Monitor therapeutic effects based on echocardiogram results.

b. Assess the client's heart rate and hold administration if it is less than 60.

A patient is experiencing nausea and visual disturbances when taking digoxin (Lanoxin). Which medication will be administered? a. Acetylsalicylic acid (aspirin) b. Digoxin immune fab (Digibind) c. Nesiritide (Natrecor) d. Felbamate (Felbatol)

b. Digoxin immune fab (Digibind

The pharmacology instructor is describing medications that increase the contractile force of the heart. Which term describes this effect? a. Negative dromotropic b. Positive inotropic c. Positive chronotropic d. Negative inotropic

b. Positive inotropic

A nurse caring for a patient with atrial fibrillation who is started on digitalis is required to monitor plasma digitalis levels in the patient's blood. Which plasma level of digitalis indicates that the nurse should report to the practitioner? a. 1.8 ng/ml b. 2 ng/ml c. 2.2 ng/ml d. 1.6 nanograms (ng)/ml

c. 2.2 ng/ml A plasma digitalis level of more than 2 ng/ml would require the nurse to report to the practitioner because it indicates digitalis toxicity. The therapeutic levels of plasma digitalis are 0.5 to 2 ng/ml.

A male client states that he is seeing halos around lights. The client takes digoxin (Lanoxin) by mouth every day. The health care provider orders the client to have serum digoxin level drawn. Which of the digoxin levels indicate the client is experiencing toxicity? a. 0.5 nanograms per milliliter b. 2.0 nanograms per milliliter c. 4.0 nanograms per milliliter d. 1.0 nanograms per milliliter

c. 4.0 nanograms per milliliter

A 58-year-old man is admitted to the emergency department. A diagnosis of severe digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG) confirms toxicity. The nurse will administer which drug? a. Furosemide b. Dopamine c. Digoxin immune fab d. Captopril

c. Digoxin immune fab

A physician orders digoxin (Lanoxin) for a client with heart failure. During digoxin therapy, which laboratory value may predispose the client to digoxin toxicity? a. Calcium level of 7.5 mg/dl b. Sodium level of 152 mEq/L c. Potassium level of 2.8 mEq/L d. Magnesium level of 2.5 mg/dl

c. Potassium level of 2.8 mEq/L

An instructor is teaching a class about vasodilators and their action for alleviating heart failure. The instructor determines that the class has understood the material when they identify what as being involved? a. Decreasing blood volume b. Increasing preload c. Reducing afterload d. Increasing myocardial oxygen use

c. Reducing afterload

What is a goal of spironolactone therapy for a client being treated for heart failure (HF)? a. The client will exhibit increased serum potassium levels. b. The client will not require inotropes or beta-blockers. c. The client will experience a decrease in edema. d. The client will resume prediagnosis levels of stamina.

c. The client will experience a decrease in edema.

A client is being treated for heart failure. Which is most indicative of improved health status? a. heart rate of 52 b. improved sensorium c. decreased pitting edema d. increased skin turgor

c. decreased pitting edema

A male client is diagnosed with heart failure. The health care provider orders a loading dose of digoxin. Loading doses are necessary for what reason? a. The client is at risk for dysthymia with titrated doses. b. Oral digoxin is ineffective for the treatment of heart failure. c. Digoxin's short half-life increases the risk for toxicity. d. Digoxin's long half-life makes therapeutic serum levels difficult to obtain without loading.

d. Digoxin's long half-life makes therapeutic serum levels difficult to obtain without loading.

The nurse is preparing to administer digoxin to a 9-month-old infant. What must the nurse do prior to administration of this medication? a. Monitor the infant's temperature b. Monitor the infant's blood pressure c. Monitor the infant's respiratory rate d. Monitor the infant's apical pulse

d. Monitor the infant's apical pulse

A nurse assessing a client on digoxin suspects toxicity. Which visual disturbances would the nurse expect to assess? a. Complete loss of vision b. Double vision c. Difficulty of near vision d. Yellow or green vision

d. Yellow or green vision The visual disturbance the nurse should assess for is yellow or green vision with a white halo. Visual disturbances occur in digoxin toxicity.