Pharmacology Exam #2 Chapters 22, 23, 24
Which are expected effects of Digitalis (cardiac glycosides)
Decreased heart rate, Positive inotropic effects
The nurse monitors a pt receiving digoxin closely for toxicity when which other medication is subscribed?
Furosemide (Lasix)
A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take?
Check the pt apical pulse, and if it is within a safe range, administer the digoxin.
A pt has been taking digoxin (Lanoxin) 0.25mg, and furosemide (lasix)
Check the pt for other symptoms of digitalis toxicity
The nurse is performing pain assessment on a pt admitted for evaluation of angina. Which type of angina is precipitated by physical exertion and is relieved by rest?
Chronic stable
What action is often recommended to help reduce tolerance to transdermal nitroglycerin therapy?
Remove the patch at bedtime, and then apply a new one in the beginning
Which drug will be administered to a pt being admitted with severe digoxin intoxication?
Digoxin immune Fab (Digibind)
A pt is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room with the morning medications, the pt states "I am seeing a funny yellow color around the lights" What is the nurse's next action?
Assess the pt for symptoms of digoxin toxicity.
What will the nurse advise the pt to do to avoid the development of tolerance to nitroglycerin?
Allow for a daily 8-12 hour nitrate free period
While assessing a pt who is taking a beta blocker for angina, the nurse knows to monitor for which adverse effect?
Bradycardia
How do beta adrenergic blocking agents reduce myocardial oxygen demand?
By inhibiting the stimulation of epinephrine
The nurse is teaching a pt about nitroglycerin prior to discharge to home. Which instruction will the nurse provide the pt?
Carry the medication with you at all times
While assessing a pt who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. How would this drug effect be evident in the pt?
Decreased heart rate
When starting a pt on antidysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?
Dysrhythmias
How frequently are nitroglycerin tablets discarded and prescriptions refilled?
Every 6 months
A pt has been diagnosed with angina and will be given a prescription for sublingual nitroglycerin tablets. When teaching the pt how to use sublingual nitroglycerin, the nurse will include which instruction?
If the chest pain is not relieved after one tablet,call 911 immediately
The nurse transcribes a new order for a daily diuretic on a pt diagnosed with congestive heart failure. The nurse will schedule this medication
In the morning
Which agents stimulate the heart to increase the force of contractions, thereby increasing cardiac output?
Inotropic
The nurse is providing education about the use of sublingual nitroglycerin tablets. She asks the pt, "What would you do if you experienced chest pain while mowing your yard? You have your bottle of sublingual nitroglycerin with you." Which actions by the patient are appropiate in this situation?
Place a tablet under the tongue Stop the activity, and lie down or sitdown Take another sublingual tablet if chest pain is not relieved after 5 minutes, up to 3 total Call 911 if the pain is not relieved after taking one sublingual tablet
In assessing a pt before administration of a digoxin (AKA cardiac glycoside), the nurse knows that which lab result can increase the toxicity of the drug?
Potassium level 2.8 mEq/L
When applying transdermal nitroglycerin patches, which instruction by the nurse is correct?
Rotate application sites with each dose
A pt will be discharged on quinidine sulfate (Quinidex) extended-release tablets for the treatment of ventricular ectopy. The nurse will include which information in the teaching plan?
Signs of cinchonism, such as tinnitus, loss of hearing, or slight blurring of vision, may occur.
A 74 year old professional golfer has chest pain that occurs toward the end of his golfing games. He says the pain usually goes away after one or two sublingual nitroglycerin tablets and rest. What type of angina is he experiencing
Stable
Which instruction will the nurse include for a pt prescribed sublingual nitrate PRN for angina?
Take one tablet and then seek medical attention if the pain is not relieved within 5 minutes
A pt has been taking digoxin at home but took an accidental overdose and has developed toxicity. The pt has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). The pt asks the nurse why the medication is ordered. What is the nurse's best response?
This drug is an antidote to digoxin and will help lower the blood levels
Which response will the nurse provide when a pt complains of a headache when using sublingual nitroglycerin?
This is a common adverse effect that can be managed with acetaminophen
When teaching a pt who has a new prescription for transdermal nitroglycerin patches, the nurse tells the pt that these patches are most appropiately used for which situation?
To prevent the occurrence of angina
A pt about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What will the nurse do next?
Withhold the dose, and notify the prescriber
