CARDIO ATI

A nurse is caring for a client who will begin using transdermal nitroglycerin to treat angina pectoris. When speaking to the client about the drug, which of the following instructions should the nurse include?

-Apply the patch to a hairless skin area and rotate sites -Apply a new patch when you start the day -Remove patches 10 to 12 hours each day Hair can interfere with the adhesion of the patch. Rotating patch application sites helps prevent skin irritation Therapeutic preventative effects of transdermal nitroglycerin patches begin 30-60 min after application and last for up to 14hours . because angina pain is more likely to occur with activity, most clients require this protection during waking hours. Removing the patch for 10-12hrs each day helps prevent the development of tolerance to the drug. Sleeping hours are the best time to remove the patch because angina pain is more likely during activity.

A nurse is caring for a client who has a new prescription for aliskiren to treat hypertension. The nurse should monitor the client for which of the following findings as an adverse effect of the drug?

-Hyperkalemia -Throat swelling -Cough aliskiren (direct renin inhibitor) can cause elevated K+ levels when taken in combination with an ACE inhibitor, potassium supplements, or potassium-sparing diuretics aliskiren can cause angioedema (swelling of the mouth and throat) aliskiren can cause cough

A nurse is caring for a client who is about to begin captopril therapy. Which of the following adverse effects should the nurse instruct the client to report because it can indicate a need to discontinue drug therapy?

-Rash-Distorted taste -Swelling of tongue -Dry cough Captopril, an ACE inhibitor, can cause a persistent rash (indicating the need to discontinue) Captopril can cause distortions in taste sensations and loss of taste which can lead to anorexia and weight loss (indicating the need to discontinue) Catopril can cause angioedema (manifesting in the tongue, pharynx, and glottis)

A nurse is teaching a client who has a new prescription for gemfibrozil. Which of the following instructions should the nurse include?

-Report any new tolerance to fried foods. -Report muscle tenderness. -Expect periodic liver function testing is correct. Gemfibrozil, a fibrate can cause gallstones. Client should monitor any new intolerance to fried foods as well as any bloating or upper abdominal discomfort Gemfibrozil, a fibrate can cause myopathy, patients should monitor and report any unexplained muscle or joint pain Gemfibrozil, a fibrate increases the risk for liver toxicity, clients will require liver function testing while taking this drug

A nurse should recognize that milrinone is contridicated for a client who has which of the following conditions?

Acute myocardial infarction Milrinone, a phosphodiesterase inhibitor, is contraindicated for clients who have had an allergic rxn to phosphodiesterase inhibitors and for clients who have an acute myocardial infraction and aortic or pulmonary valve disorders.

A nurse is caring for a client who is taking digoxin and develops changes on their ECG tracing and other maneifestations that indicate the client has severe digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication?

Antigen-binding fragments

A nurse is providing teaching to a client who has a new prescription for losartan to treat hypertension. The nurse should instruct the client that which of the following findings could indicate an adverse reaction to the drug and needs to be reported?

Facial Edema Losartan, an angiotensin II receptor blocke, can cause angioedema, which often manifests as swelling around the eyes and lips. Pts should stop taking the drug and seek medical attention.

A nurse is caring for a client who is taking amiodarone to treat atrial fibrillation. Which of the following should the nurse instruct the client to avoid while taking this drug?

Grapefruit Juice large amounts can cause toxicity of potassium channel blockers such as amiodarone

A nurse is teaching a client who has a new prescription for nitroglycerin. The nurse should instruct the client that which of the following manifestations is a potential adverse effect of the drug?

Headache Adverse effects of nitrates, such as nitroglycerin, includes headaches, which can be severe at the beginning of nitrate therapy but decrease in severity with continued exposure to nitrates.

A nurse is administering hydrochlorothiazide to a client who has arthritis. The nurse should monitor the client for which of the following findings that indicates an adverse effect of this drug?

Hyperuricemia Hyperuricemia(increased uric acid lvls) along with gouty arthritis can occur in clients who have a history of these conditions and are taking hydrochlorothiazide.

A nurse is caring for a client who is taking carvedilol and has a prescription for an oral antidiabetic drug to manage their new diagnosis of type 2 diabetes mellitus. By taking both drugs concurrently, the nurse should identify that the client is at an increased risk for which of the following conditions?

Hypoglycemia Carvedilol (alpha/beta blocker) potentiate the hypoglycemic effects of insulin and oral hypoglycemic drugs. Carvedilol can mask tachycardia in clients who have hypoglycemia and should be used with caution in patients who have diabetes mellitus

A nurse is assessing a client who is taking a loop diuretic and is experiencing a thready, irregular pulse, orthostatic hypotension, and confusion. The nurse should identify that these manifestations indicate which of the following adverse effects?

Hypokalemia Manifestations of hypokalemia include a thready irregular pulse, orthostatic hypotension, anxiety, confusion, skeletal muscle weakness, hypoactive bowel sounds, polyuria, nausea, and vomiting.

A nurse is caring for a client who has a new prescription for verapamil to treat atrial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking verapamil because it can cause the client to experience which of the following conditions?

Hypotension Large amounts of grapefruit juice can increase blood levels of verapamil by inhibiting its metabolism.

A nurse is caring for a client who has a new prescription for dobutamine. The nurse should clarify the prescription with the provider if the client is receiving which of the following types of drugs?

MAOI, General Anesthetic, Tricyclic antidepressant, Beta Blocker MAOIs can cause toxicity when clients take them while also taking dobutamine. This significantly increases the clients risk's for tachydysrhythmias. General anesthetics can cause dysrhythmias when clients take them while also taking dobutamine. Tricyclic antidepressants can cause toxicity when clients take them while also taking dobutamine. This significantly increases the clients risk's for tachydysrhythmias.

A nurse is teaching a client who has a new prescription for quindine. Which of the following statements should the nurse include?

Monitor your pulse rate and report changes Sodium channel blockers like quinidine, can worsen dysrhythmias, or cause new ones. The nurse should teach the client to monitor pulse rate and report changes from prescribed parameters.

A health care professional is caring for a patient who is about to begin taking simvastatin (Zocor) to treat hypercholesterolemia. The health care professional should tell the patient to report which of the following indications of a serious adverse reaction that could warrant stopping drug therapy?

Muscle Pain

A nurse is caring for a client who is taking atorvastatin and has a new prescription for gemfibrozil. The nurse should recognize that this drug combination places the client at an increased risk for which of the following adverse effects?

Myopathy Statin drugs: important to know that concurrent use of fibric acid derivatives (gemfibrozil) or other drugs to lower cholesterol, can increase the risk for myopathy

The nurse is caring for a client who has a new prescription for propranolol to treat a tachydysrhythmia. The nurse should instruct the client to avoid which of the following types of over the counter drugs while taking propranolol?

NSAIDS NSAIDs can interact with propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX-2 inhibitors.

A nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client laboratory value requires immediate intervention?

Potassium of 5.2 mEq/L Spironolactone is a diuretic and aldosterone antagonist that can cause hyperkalemia and places the client at risk for cardiac dysrhythmias.

A nurse should identify that which of the following drugs is used only for the short term treatment of a cardiac dysrhythmia because of the serious adverse effects associated with long term use?

Procainamide

A nurse is caring for a client who is taking a diuretic. The nurse should instruct the client to include which of the following foods in their diet to increase potassium intake?

Raisins Diuretics can deplete the body of potassium, so the nurse should instruct the client to include potassium-rich foods in their diet, such as raisins and other dried fruits.

A nurse is caring for a client who has a depressive disorder and requires a prescription drug to treat hypertension. The nurse should recognize that which of the following antihypertensive drugs is contraindicted for this client?

Reserpine

A nurse is caring for a client who has a new prescription for verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions?

Second-degree AV block verapamil (calcium channel blocker) can affect AV conduction and is contraindicated for patients who have sick sinus syndrome or second or third degree AV block. verapamil is indicated for hypertension, angina pectoris, and the management of atrial flutter and fibrillation. It is also prescribed for the management of migraine headaches

A nurse is reviewing new prescriptions with a client who has heart disease. The nurse should instruct the client that which of the following drugs is prescribed to treat hypercholesterolemia?

Simvastatin Simvastatin is an HMG-CoA reductase inhibitor. it blocks synthesis of cholesterol by the body to help lower cholesterol levels

A nurse is caring for a client who has glomerular filtration rate of 10 mL/min and a reduced urine output. The nurse should clarify a prescription for hydrochlorothizaide for this client because of which of the following characteristics of the drug?

The drug does not promote diuresis for patients who have renal insufficiency. Adequate kidney function is essential for clients who take hydrochlorothiazide, a thiazide diuretic, to promote urine production and effective excretion.