Chapter 27: Drugs Used to Treat Heart Failure

A patient with altered cardiac function is being assessed by the nurse. When auscultating lung sounds, the nurse will assist this patient into a _____ position.

Fowler's

The nurse monitors a patient receiving digoxin closely for toxicity when which other medication is prescribed?

Furosemide (Lasix)

Which contributing factor(s) to heart failure is/are modifiable? (Select all that apply.)

a. Hypertension b. Addiction to smoking d. Exercise tolerance ANS: A, B, D

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?

"Report nausea and vomiting to your health care provider."

The nurse is providing teaching to a patient with heart failure who has been prescribed nifedipine, a calcium channel blocker. Which statement by the nurse is accurate?

"This medication reduces the resistance your heart has to pump against."

The nurse is to administer digoxin to an 18-month-old patient who weighs 16.5 lb. Guidelines for administration read as follows: 0.0075 to 0.010 mg/kg/day. Which is a safe medication dosage?

0.074 mg

Which drug is used to obtain vasodilation in the treatment of chronic heart failure?

ACE inhibitors

The nurse is caring for a 3-year-old girl who has a congenital heart anomaly. The patient's current medications include digoxin and furosemide (Lasix). The apical pulse rate is 100 beats/min. Which action will the nurse take?

Administer the medication.

Which is the initial manifestation of digoxin toxicity in children?

Atrial dysrhythmia

Which nursing assessment is most important to determine fluid status for a patient with heart failure?

Daily weights

Which drug will be administered to a patient being admitted with severe digoxin intoxication?

Digoxin immune Fab (Digibind)

Which action of ACE inhibitors results in effective treatment of heart failure?

Increased cardiac output

Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?

Inotropic

An older adult male patient with long-term heart failure has presented for an office visit. The nurse obtains information that he has recently begun taking St. John's wort. What results with the use of this herbal supplement?

Reduced therapeutic benefits of digoxin

Before administering digoxin (Lanoxin), the nurse takes the adult patient's apical pulse for 1 full minute. What additional nursing consideration(s) will be taken before administration of the medication? (Select all that apply.)

a. Review of the digoxin blood level c. Review of serum electrolytes, liver, and kidney function studies e. Obtaining baseline patient assessment data, including lung sounds, vital signs, and weight ANS: A, C, E

Which statement(s) about vasodilators is/are true? (Select all that apply.)

a. They reduce systemic vascular resistance. c. They reduce preload. d. They decrease pulmonary congestion. e. They increase tissue perfusion to muscles and organs. ANS: A, C, D, E

Which action(s) will the nurse take when caring for a patient with heart failure? (Select all that apply.)

b. Assess electrolyte levels. c. Report daily weight fluctuations. e. Maintain skin hygiene. ANS: B, C, E

A patient with heart failure has been prescribed nesiritide (Natrecor). Which statement(s) is/are true regarding this medication? (Select all that apply.)

b. Cardiac ventricles secrete this hormone in response to fluid overload. c. It suppresses aldosterone. e. It causes vasodilation. ANS: B, C, E

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI). Which symptom(s) would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.)

c. Diminished exercise tolerance d. Shortness of breath with activity ANS: C, D

The nurse is providing education to a patient with altered cardiac function. When instructing this patient the nurse will encourage (Select all that apply.)

c. regular, mild exercise. d. good skin care. e. stress reduction. ANS: C, D, E

The nurse transcribes a new order for a daily diuretic on a patient diagnosed with congestive heart failure. The nurse will schedule this medication

in the morning.