Cardiac Medications Comprehensive
IV furosemide has been prescribed for a client with severe edema and hypertension. Which subjective clinical manifestations lead the nurse to suspect the furosemide is infusing too rapidly? One or more may be correct. a. Hunger b. Tinnitus c. Excess salivation d. Leg cramps e. Weakness
b,d,e
Which medications require lab monitoring? a. enoxaparin b. warfarin c. rivaroxaban d. heparin sodium e. digoxin
b,d,e
What are 2 primary nursing considerations when administering atorvastatin?
- S/S of rhabdomyolysis - Monitoring labs (BG, LFTs, LDL)
Select all of the common objective findings in patients with left sided heart failure. a. pulmonary edema b. crackles c. cough d. dyspnea
ALL
A patient has been on captopril for a few days. They have now developed a dry hacking cough and have requested a new medication. Which medication could the provider order instead? a. none captopril is the only option b. losartan c. rivaroxaban d. enoxaparin
b
A patient's potassium level came back as 2.7 mEq/L. What should the nurse do with this information? a. Notify the HCP about hyperkalemia b. Notify the HCP about hypokalemia c. This is a normal result d. Quickly call a rapid response
b
It is important to closely monitor _______ levels in IV therapy to ensure in therapeutic range for heparin sodium. a. sodium b. PTT c. APPT d. potassium
b
Left sided heart failure mostly affects the ___________ a. vascular system b. lungs c. heart b. brain
b
Losartan has been prescribed for a patient. Which is an important nursing action? a. Monitor serum glucose levels b. Monitor client's blood pressure c. Administer medication with food d. Assess for hypokalemia
b
What is a normal INR range? a. 3.5-5.0 b. 2.0-3.0 c. 1.0-1.9 d. 5.0-6.9
b
What is a normal sodium range? a. 130-140 b. 135-145 c. 140-145 d. 125-135
b
What subclass does losartan belong to? a. ACE inhibitors b. ARB's c.
b
What subclass of medications may result may result in a dry hacking cough? a. ARB's b. ACE inhibitors c. Nitrates d. Diuretics
b
A patient is in the hospital and will be discharged on warfarin. The client questions why they have been prescribed warfarin and heparin sodium. Explain why.
This is called bridging. Warfarin takes 3 days to be therapeutic.
When ___________ is blocked aldosterone promotes the execration of sodium and water. a. angiotensin b. renin c. aldosterone d. digibind
b
A HCP prescribes furosemide for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in which part of the renal system? a. loop of henle b. collecting duct c. distal tubule d. glomerulus of the nephron
a
A patient who has a potassium level of 3.2 mEq what would the nurse document that as? a. hypokalemia b. hyperkalemia c. hypocalcemia d. hypercalcemia
a
Captopril is prescribed for a client. Which effect would the nurse anticipate? a. Decreased blood pressure b. Improved sleep c. Decreased anxiety d. Increased urinary output
a
Clinical findings that a nurse may find with right sided heart failure? One or more may be correct a. Ascites b. Pulmonary edema c. Angioedema d. Crepitus
a
The cardiac monitor reveals several runs of ventricular tachycardia. Which medication is used to treat this dysrhythmia? a. amiodarone b. atropine c. metoprolol d. epinephrine
a
When teaching a client about digoxin, which symptom will the nurse include as a reason to withhold the medication? a. Yellow vision b. Persistent hiccups c. Fatigue d. Increased urinary output
a
Which MOA explains how hydrochlorothiazide increases urine output? a. Increases execration of sodium b. Increases execration of potassium c. Increases renal perfusion d. Increases glomerular filtration rate
a
Which instruction would the nurse give a UAP to perform while caring for a patient on Captopril? Select all that apply a. Obtain BP b. Monitor I&O c. Weight each morning d. Notify nurse if patient has dry hacking cough e. Assist the client to change positions quickly
a,b,c,d
Which nursing interventions are important when caring for patient's receiving IV digoxin? Select all that apply a. Monitor HR closely b. Check digoxin blood levels c. Administer the dose over 1 minute d. Monitor serum potassium level e. Give the medication with other medications infusing
a,b,d
TPA is indicated for which situations? a. Pulmonary embolism b. Myocardial infarction c. DVT d. Peripheral edema e. Occluded central venous catheters
a,b,e
Select the patient teaching statements that would be given to a patient being discharged on warfarin. a. "It is important to take preventative measures to minimize your risk of bleeding." b. "You should avoid the intake of alcohol, cranberries and grapefruit as they increase the risk of bleeding." c. "It is important to have a balanced diet to have a consistent intake of sodium and potassium." d. "You need to loosely follow the prescribed dosage schedule." e. "It is vital for you to follow the INR monitoring guidelines." f. "You will need to take bleeding precautions. An example would be using a soft toothbrush."
a,b,e,f
What are the priority teaching considerations the nurse should discuss regarding nitroglycerin sublingual? Select all that apply a. tingling is expected b. no eating during admin c. smoking is ok during admin d. headaches are not common e. don't chew the tablet f. keep tabs away from light g. after dose 3 if no relief call 911
a,b,e,f,g
It is important for the nurse to know the signs of digoxin toxicity. Select the signs in which need intervention below. a. halos and spots b. nausea/vomiting c. green/yellow vision d. palpitations
a,c
A client with midsternal pain presents to the ER. Vital signs are stable. Which form of nitroglycerin would the nurse anticipate giving initially? a. transdermal patch b. sublingual spray c. Oral d. IV
b
Which nursing action is the highest priority when caring for a client receiving nitroglycerin for the treatment of angina? a. Monitoring the client's urine output b. Asking the client to sit or stand slowly c. Reporting to the HCP if pain doesn't subside within 5 minutes d. Advising the client to report when experiencing a headache
b
When a patient is on clopidogrel (Plavix) what should they avoid? Select all that apply. a. cranberries b. NSAIDS c. alcohol d. potassium rich foods
b,c
Potential effects of antihypertensives include which of the following: one or more may be correct. a. tachycardia b. impotence c. weight gain d. orthostatic hypotension e. rebound hypertension
b,c,d
A client diagnosed with a TIA related to hypertension is discharged with a prescription for hydrochlorothiazide. Which instruction would the nurse include in the teachings for this medication? a. Drink a protein supplement everyday b. Resume regular eating habits c. Increase your intake of potassium rich foods d. Avoid eating foods high in insoluble fiber
c
A client with a myocardial infarction receives IV nitroglycerin to relieve pain. Which side effect will the nurse assess for? a. nausea b. delirium c. hypotension d. bradycardia
c
A patient receives a cardiac glycoside, a diuretic, an ACE inhibitor, and a vasodilator. The client's apical pulse is 44 BPM. The nurse concludes that the client's decreased HR is a result of which medication? a. vasodilator b. diuretic c. cardiac glycoside d. ACE inhibitor
c
Select the ideal therapeutic range of digoxin a. 0.8 - 1.2 b. 0.6 - 1.2 c. 0.8 - 2.0 d. 0.6 - 2.0
c
Valsartan, an angiotensin II receptor antagonist, is prescribed for a client. For which possible side effects should the nurse monitor the client? a. Constipation b. Hypertension c. Hyperkalemia d. Change in visual acuity
c
What are the clinical manifestations a nurse would see if digoxin was being therapeutic? One or more may be correct a. Clear lung sounds b. Increased BP c. Decreased HR d. No anginal pain
c
What can happen is nitroglycerin was administered to a patient who had taken a sildenafil? a. profound bradycardia b. rebound hypertension c. profound hypotension d. orthostatic hypotension
c
What can happen to a client who has toxic levels of digoxin? a. rebound hypertension b. profound hypotension c. profound bradycardia d. rebound tachycardia
c
What is a normal potassium range? a. 3.2-5 b. 3-4.6 c. 3.5-5 d. 3.6-5.2
c
Which medication cannot be given in conjunction with organic nitrates? a. sprilolactone b. metoprolol c. sildenafil d. losartan
c
Which medication would the nurse monitor for hyperkalemia? a. digoxin b. captopril c. spironolactone d. metolazone
c
A client has been prescribed furosemide 40 mg everyday in conjunction with digoxin. Which concern would prompt the nurse to ask the HCP about potassium supplements? a. Digoxin causes significant potassium depletion b. The liver destroys potassium as digoxin is detoxified c. Lasix requires adequate serum potassium to promote diaphoresis d. Digoxin toxicity occurs rapidly in the presence of hypokalemia
d
A client is admitted to the hospital with a diagnoses of heart failure and acute pulmonary edema. The HCP prescribed furosemide 40 mg IV STAT to be repeated in the hour. Which nursing action will BEST evaluate the effectiveness of the furosemide managing the patient's condition? a. Performing daily weights b. Monitoring intake and output c. Assessing for dependent edema d. Auscultating breath sounds
d
A client who has a history of a fib and has been taking warfarin as part of their normal meds. The client fell at home and was instructed to come to the ER promptly to be evaluated. The client has labs drawn and is then taken to CT. Their INR is 4.6 and they have no cerebral hemorrhage. What reversal agent should the nurse prepare to administer? a. digibind b. activated charcoal c. potassium d. vitamin K
d
How would the nurse know if a patient is responding therapeutically to digoxin? a. increased HR b. decreased BP c. increased BP d. decreased HR
d
Sublingual nitroglycerin has been prescribed for a patient with unstable angina. Which client response indicates that nitroglycerin is effective? a. Capacity of activity improves as a response to increased collateral circulation b. Sublingual area tingles d/t sensory nerves being stimulated c. Pulse rate increases as cardiac output increases d. Pain subsides as a result of arterial/venous dilation
d
When the client is taking a loop diuretic asks the nurse why changing positions slowly is important, which response will the nurse provide? a. Your high BP will cause headaches with sudden movement b. You will experience potassium fluctuations which will affect your balance c. You will need to rush to the bathroom while on a diuretic and we want to be sure you are safe d. Your blood pressure will drop with position changes, leading to dizziness and a risk of falling.
d
Which assessment is necessary for a patient on loop diuretics who has chronic kidney disease? a. hemoglobin levels b. I & O c. Occurrence of nausea d. Presence of constipation
d
Which client response must the nurse monitor to determine the effectiveness of amiodarone? a. Improvement of fasting lipid profile b. Maintenance of BP control c. Absence of ischemic chest pain d. Decrease in cardiac dysrhythmias
d
Which information about the client who has heart failure would the nurse communicate to the HCP before administration of the prescribed digoxin? a. Apical pulse of 98 BPM b. Crackles heard at bases of lungs c. Bilateral foot and ankle pitting edema d. Potassium level 2.3 mEq/L
d
The nurse knows that the direct-acting thrombin inhibitors prototype is what?
dabigatran (Pradaxa)
Is enoxaparin given in conjunction with rivaroxaban?
no
The nurse knows that losartan causes (vasoconstriction/vasodilation).
vasodilation
