Pharm II Final

A client presents to the Emergency Department with rales, wheezing, and blood-tinged sputum. The nurse suspects that the client is in congestive heart failure (CHF). What would the nurse suspect the client is experiencing?

Pulmonary edema

A client being treated for hypokalemia has a medication history that includes propranolol, digoxin, and warfarin. When the client reports nausea, abdominal discomfort, and visual changes, the nurse suspects what as the causative factor?

Digitalis toxicity

What is given to treat a massive digoxin overdose?

Digoxin immune Fab (Digibind)

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?

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

Before administering a beta-adrenergic blocker, the nurse should be aware of what information about the client?

Pulse and blood pressure

A client is hospitalized for heart failure and is scheduled to receive oral digoxin at 8 AM. The nurse with withhold the medication and notify the prescriber if the client's:

Pulse is 52 bpm

The nurse is providing teaching to a patient who has been prescribed digoxin. The patient tells the nurse that the patient occasionally uses herbs and alternative therapies. It would be important for the nurse to instruct the patient to avoid combining digoxin with:

Ginseng

The client has crackles in the lower lobes of the lungs, and audible S3, and pitting edema in the feet and ankles. What condition is the client most likely experiencing?

Heart failure

A resident of a long-term care facility receives 12.5 mg metoprolol (Lopressor) at 8 AM and 8 PM daily. Before administering this drug, the nurse should perform and document what assessment findings?

Heart rate and blood pressure

A client who has been prescribed digoxin (Lanoxin) is also taking furosemide (Lasix) 20 mg daily. Which electrolyte imbalances will precipitate the client to develop digoxin toxicity?

Hypokalemia

The nursing instructor is discussing digoxin-induced dysrhythmias. What risk factor would the instructor identify as increasing risk for dysrhythmia in a client taking digoxin?

Hypokalemia

Milrinone (Primacor) is a miscellaneous inotropic drug used in the short-term management of heart failure. What is the only way this drug is approved to be administered?

Intravenously

When educating a group of nursing students on the mechanisms of action of digitalis, the nursing instructor identifies which pharmacologic actions of digitalis? (3)

It increases cardiac output by positive inotropic action it decreases the HR through negative chronotropic effect It retards the conduction velocity through the AV node in the heart

A male client has been admitted with digitalis toxicity. He has been taking the same dose for more than 20 years. His family is asking how common this problem is and how he developed a toxic level while taking the usual dose. The nurse's best explanation would be:

Toxicity can occur even on low- dose therapy due to various factors including advanced age

Which would a nurse expect to assess if a client is experiencing right-sided heart failure??

Peripheral edema

A nurse is giving medication instruction to a client who is taking metoprolol (Lopressor). Which statement by the client would indicate that teaching has been effective?

"I should never stop taking this drug abruptly."

Digoxin has been prescribed for an out-client with symptomatic heart failure. What is the priority teaching point to convey to this client?

"Make sure to take your pulse for a minute before taking your digoxin."

Which serum digoxin level would the nurse interpret as indicating digoxin toxicity?

2.3 ng/mL

A male client has called the clinic because he is taking digoxin and is concerned about his pulse rate. The nurse should tell the client to hold the medication if he reports a pulse rate of:

52 bpm

The nurse suggests which dietary habits for the client with heart failure? (2)

Decrease calories to lose weight if needed. Try to include vegetables, protein, and carbohydrates in each meal.

What does the use of cardiotonics lead to? (3)

Improved myocardial contractility Increased myocardial efficiency Improved perfusion to all body tissues

Which drug is in the class of drugs called human B-type natriuretic peptides?

Nesiritide (Natrecor)

The pharmacology instructor is discussing effects on the heart of different medication. What is the term the instructor would use to describe the effect of a medication that increases the force of the contractions of the heart?

Positive inotropic

What will occur when oxygen is administered to a client in heart failure? (4)

Relieve dyspnea Reduce the work of breathing Decrease constriction of pulmonary blood vessels Improve oxygen delivery

What assessment should the nurse make before administering beta-adrenergic blocking agents?

The pulse and blood pressure