Cardiotonic

1. Digoxin is part of what family of drugs?* A. Angiotensin-converting enzyme inhibitors B. Beta-blockers C. Angiotensin II receptor blockers D. Cardiac glycosides

D

Which statement Would best fit the action of digoxin ? A. "Increase cardiac output through positive inotropic activity" B. Decrease conduction velocity through the SA and AV nodes C.blocks angiotensin II receptor preventing vasoconstriction D. Block secretory action in the sympathetic nervous system

"Increase cardiac output through positive inotropic activity"

phophodiesterase inhibitor end in

-rinone

Which digoxin lab result would be reported to the HCP?

3.7

Number the nursing actions below in order of priority for the step-by-step management of digoxin toxicity. Use all actions listed below. 1.Administer potassium supplements for hypokalemia if indicated, as ordered 2.Begin continuous ECG monitoring for cardiac dysrhythmias 3.Administer digoxin antidote (digoxin immune Fab, digibind), if indicated, as ordered 4.Discontinue administration of the drug 5.Determine serum electrolytes and serum digoxin levels

4,2.5,1,3

The nurse is preparing the client's scheduled medications, one of which is digoxin. For which of the following vital signs would the nurse hold the client's digoxin dose? A.A heart rate of 55 bpm B.A blood pressure of 198/101 mmHg C.A respiratory rate of 27 breaths per minute D.An oral temperature of 99.8F

A

6. An adult patient is being discharged home on Digoxin. Which statements below verbalized by the patient demonstrates they understand how to properly take this medication? Select all that apply:* A. "I will limit by intake of foods high in potassium." B. "I will not take this medication and notify the physician if my heart rate is less than 70 bpm." C. "I will measure my pulse rate before every dose I take." D. "It is important that I immediately report any vision changes I may experience while taking this medication."

A,C,D

Which is the MOST appropriate action for the nurse to take before administering digoxin? A.Monitor potassium level B.Assess blood pressure C.Evaluate urinary output D.Avoid giving with thiazide diuretic

A.

Which result would alert the nurse the digoxin treatment is effective ? A.The patient urine output increased B. The patients weight increased C. The patient presents with a 3+ pitting edema D. The patient becomes fatigue with activity

A.

A patient is taking a potassium-depleting diuretic and digoxin. The nurse expects that a low potassium level (hypokalemia) could have what effect on digoxin? A. Increases serum digoxin sensitivity level B. Decreases serum digoxin sensitivity level C. No effect on serum digoxin sensitivity level D. Causes a low-average serum digoxin sensitivity level.

A. Increases serum digoxin sensitivity level

Raymund is reviewing cardiovascular drugs for his upcoming exam. For a well-prepared student, he should know that vasodilators are agents that: A. Relax smooth muscles. B. Are used to treat hypotension. C. Stimulate the adrenergic receptors of peripheral sympathetic nerves. D. Cause respiratory depression.

A. Relax smooth muscles.

An adult patient is being discharged home on Digoxin. Which statements below verbalized by the patient demonstrates they understand how to properly take this medication? Select all that apply:* A. " I will take this medication everyday at the same time B. "I will not take this medication and notify the physician if my heart rate is less than 70 bpm." C. "I will measure my pulse rate before every dose I take." D. "It is important that I immediately report any vision changes I may experience while taking this medication."

A.,C,D

Before administering digoxin what should be done

Apical pulse should be listened to for 60 secs

If digoxin causes bradycardiac arrhythmia what would be administered

Atropine

A group of nursing students are reviewing cardiotonic drugs. The students demonstrate understanding of the information when they identify which adverse reaction associated with cardiotonic medications? A.Restlessness B.Visual disturbances C.Constipation D. Diarrhea

B.

A nurse is monitoring a client who is taking Digoxin (Lanoxin). All of which are the side effects associated with the medication. except? A.Anorexia. B.Blurred vision. C.Diarrhea. D.Tremors.

B.

Class IA antiarrhythmic agents have little effect on: A.AV node B.SA node C.Purkinje fibers D.Bundle of His

B.

The nurse assesses a client before administering digoxin. What finding would cause the nurse to withhold the drug and notify the primary health care provider? A.respiratory rate of 13 breaths/min B.pulse 44 beats/min C.blood pressure 102/66 mmHg D.history revealing liver failure

B.

Which of the following is a contraindication for digoxin administration? A.Blood pressure of 140/90 B.Heart rate above 80 C.Heart rate below 60 D.Respiratory rate above 20

C

. A nurse is caring a client who is taking digoxin (Lanoxin) 0.25mcg tab once a day. The client suddenly complaints of anorexia. nausea. vomiting. and diarrhea. The physician is ruling a digoxin toxicity. As a nurse. you know the therapeutic digoxin rate is? A.0.25-0.5 ng/ml. .B.3.5-4.5 ng/ml. C. 0.8-2 ng/ml D.1.5-3 ng/ml.

C.

A client is being treated for heart failure. What assessment finding would the nurse interpret as most indicative of improved health status? Improved sensorium Increased skin turgor Decreased pitting edema Heart rate of 52

C.

Phosphodiesterase inhibitors are used to treat HF by inhibiting phosphodiesterase enzyme. What do these agents promote? A. Increased serum sodium and potassium levels B. Negative inotropic action C. Positive inotropic action D. Vasoconstriction

C.

The action of medication is inotropic when it: A.Decreased afterload B.Increases heart rate C.Increases the force of contraction D.Is used to treat CHF

C.

What is an example of a phophodiesterase inhibitor? A. Amlodipine B. Digoxin C. Milrinone D. Isosorbide dinitrate

C. Milrinone

A nurse administers digoxin (Lanoxin) to a client with heart failure. Based on the nurse's knowledge of this drug, which intervention should the nurse perform before administering it? A.Assess for pitting edema B.Assess the client's lung sounds C.Check the client's heart rate D.Monitor the client's oral intake

C.Check the clients HR

What is an example of a phophodiesterase inhibitor? A. Amlodipine B. Digoxin C.Inamrinone D.Sodium polystyrene sulfonate (Kayexalate)

C.Inamrinone

The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult client with atrial fibrillation. The client has a potassium level of 4.6 mEq/L. The nurse interprets that the: A.Dose should be omitted only for that day. B.Client needs a dose of potassium before receiving digoxin. C.Dose should be withheld and the healthcare provider notified. D. Dose should be administered as ordered.

D.

What are the Cardiotonic drugs

Digoxin

What is the Antidote for Digoxin

Digoxin immune Fab (Digibind)

If digoxin causes tachycardiac arrhythmia what would be administered

Dilantin

Mechanism of Action for digoxin

Enhance movement of calcium into myocardial cells

Routes of administration for Digoxin

PO and IVPB

This class of drugs is used short term for CHF when Digoxin doesnt work

Phosphodiesterase Inhibitors

A nurse is caring for a client who is taking digoxin and a loop diuretic. Which would be most important for the nurse to monitor? Liver enzymes Sodium levels Electrocardiogram results Potassium levels

Potassium levels

phophodiesterase inhibitor have ______________ (vasoconstricting/Vasodilating)

Vasodilating

The nurse reviews an adult patient's laboratory values and notes a digoxin level of 11 ng/mL and a serum potassium level of 6.2 mEq/L. The nurse would notify the health care provider and anticipate which medication will be prescribed to administer? a. Atropine b. Digoxin immune Fab c. Sodium polystyrene sulfonate (Kayexalate) d. Epinephrine (Adrenalin)

b. Digoxin immune Fab

2. During assessment of a patient who is receiving digoxin, the nurse monitors for findings that would indicate an increased possibility of toxicity, such as: a. apical pulse rate of 62 beats/ min. b. digoxin level of 1.5 ng/ mL. c. serum potassium level of 2.0 mEq/ L.d. serum calcium level of 9.9 mEq/ L. d. serum calcium level of 9.9 mEq/ L.

c. serum potassium level of 2.0 mEq/ L.d. serum calcium level of 9.9 mEq/ L.

Digoxin can be used to treat

cardiac arrythmias and heart failure

milironone____________ (increases/decreased) BP

decreases

Cardiotonics are also called

digitalis glycosides or Cardiac Glycosides

Cardiotonics are used to treat

heart failure, atrial fibrillation and and atrial flutter and SVT