Saunders-Pharm (CV)

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.

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 AV block

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?

1hr before meals

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 mg/mL

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 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.

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 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)

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 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 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.

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

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?

HTN

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 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.

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 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.

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

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

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 LDLs

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

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?

K level of 2.9

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 is caring for a client who suddenly starts complaining of palpitations, restlessness, and anxiety. The nurse obtains a stat electrocardiogram (ECG) which shows A-fib. 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 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 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

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.

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?"

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 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 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 K level of 3.1

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 K level of 5.8

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?

aPTT of 60 sec

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

acetylsalicylic acid

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 is monitoring a client who is taking digoxin for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply. a) tremors b) diarrhea c) irritability d) blurred vision e) n/v

b, d, e

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. a) "I may take over-the-counter medications as needed." b) I will inform my dentist that I am taking this medication." c) "I should alternate the timing of my daily dose of this medication." d) "I should use a firm-bristled toothbrush to prevent the side effects of this medication." e) "I will have my blood levels checked as prescribed by my primary health care provider (PHCP)." f) "I will report any signs of blood in my urine or stool to my primary health care provider (PHCP)."

b, e, f

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

blood pressure

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

bumetanide

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? SATA a) call a Code Blue. b) Contact the client's family. c) Assess the client's pain level. d) Check the client's blood pressure. e) Contact the primary health care provider (PHCP). f) Administer a second nitroglycerin, 0.4 mg sublingually.

c, d, f

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? SATA a) Vertigo b) Dysuria c) Epistaxis d) Hematuria e) Ecchymosis

c-e

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 HCP

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

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 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 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 BP

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 LFTs

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

he client will have an increase in urine output.

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?

headaches

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?

hrombolytics act to dissolve thrombi that have already formed.

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, hyperlgycemia, sulfa allergy

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?

liver cancer

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

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

peripheral vasoconstriction

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 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?

plapitations

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

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

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

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

take the dose in the morning

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 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?

vitamin K

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 2-3lbs in a few days