Chapter 42
A patient is taking digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg. The patient tells the nurse, "There are yellow halos around the lights." Which action will the nurse take? Evaluate digoxin levels. Withhold the furosemide. Administer potassium. Document the findings and reassess in 1 hour.
1
A patient is to be discharged with a transdermal nitroglycerin patch. Which instruction will the nurse include in the patient's teaching plan? "Apply the patch to a non-hairy area of the upper torso or arm." "Apply the patch to the same site each day." "If you have a headache, remove the patch for 4 hours and then reapply." "If you have chest pain, apply a second patch next to the first patch."
1
A patient's serum digoxin level is noted to be 0.4 ng/mL. What is the nurse's priority action? Administer ordered dose of digoxin. Hold future digoxin doses. Administer potassium. Call the health care provider.
1
Which assessment finding will alert the nurse to suspect early digitalis toxicity? Loss of appetite with slight bradycardia Blood pressure of 90/60 mm Hg Heart rate of 110 beats per minute Confusion and diarrhea
1
Which patient assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker? Absence of chest pain Decreased swelling in the ankles and feet Patient denies dizziness. Patient states that she feels stronger.
1
A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse's priority action? Assess the patient's lung sounds. Decrease the intravenous nitroglycerin by 10 mcg/min. Stop the nitroglycerin infusion for 1 hour and then restart. Continue the infusion and recheck the patient's vital signs in 15 minutes.
2
The patient asks the nurse how nitroglycerin should be stored while traveling. What is the nurse's best response? "You can protect it from heat by placing the bottle in an ice chest." "It's best to keep it in its original container away from heat and light." "You can put a few tablets in a resealable bag and carry in your pocket." "It's best to lock them in the glove compartment to keep them away from heat and light."
2
What instruction should the nurse provide to the patient who needs to apply nitroglycerin ointment? Use the fingers to spread the ointment evenly over a 3-inch area. Apply the ointment to a non-hairy part of the upper torso. Massage the ointment into the skin. Cover the application paper with ointment before use.
2
When titrating intravenous nitroglycerin for a patient, what is important for the nurse to monitor? (Select all that apply.) Continuous oxygen saturation Continuous blood pressure Hourly ECGs Presence of chest pain Serum nitroglycerin levels Visual acuity
2,4
A nurse is caring for a patient who has been started on ibutilide (Corvert). Which assessment is a priority for this patient? Blood pressure measurement BUN and creatinine ECG Lung sounds
3
A patient is being treated for short-term management of heart failure with milrinone (Primacor). What is the primary nursing action? Administer digoxin via IV infusion with the milrinone. Administer furosemide (Lasix) via IV infusion after the milrinone. Monitor blood pressure continuously. Maintain an infusion of lactated Ringer's with milrinone infusion.
3
Before the nurse administers isosorbide mononitrate (Imdur), what is a priority nursing assessment? Assess serum electrolytes. Measure blood urea nitrogen and creatinine. Assess blood pressure. Monitor level of consciousness.
3
A nurse is monitoring a patient with angina for therapeutic effects of nitroglycerin. Which assessment finding indicates that the nitroglycerin has been effective? Blood pressure of 120/80 mm Hg Heart rate of 70 beats per minute ECG without evidence of ST changes Patient stating that pain is 0 out of 10
4
The nurse is monitoring a patient during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action? Blood pressure 110/90 mm Hg Flushing Headache Chest pain
4
Which statement indicates to the nurse that the patient understands sublingual nitroglycerin medication instructions? "I will take up to five doses every 3 minutes for chest pain." "I can chew the tablet for the quickest effect." "I will keep the tablets locked in a safe place until I need them." "I should sit or lie down after I take a nitroglycerin tablet to prevent dizziness."
4
Which statement made by the patient demonstrates a need for further instruction regarding the use of nitroglycerin? "If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief." "I should keep my nitroglycerin in a cool, dry place." "I should change positions slowly to avoid getting dizzy." "I can take up to five tablets at 3-minute intervals for chest pain if necessary."
4
