PrepU Cardiovascular Disorders
The client is to receive digoxin 0.25 mg. Available are 0.125-mg scored tablets. How many tablets should the nurse administer? 1 tablet 0.5 tablet 1.5 tablets 2 tablets
2 tablets 0.25 mg/x tablets = 0.125 mg/1 tablet. x = 2 tablets.
The monitor technician informs the nurse that the client has started having premature ventricular contractions every other beat. What should the nurse do first? Activate the rapid response team Call the health care provider (HCP) Assess the client's orientation and vital signs Administer a bolus of lidocaine
Assess the client's orientation & vital signs The priority action is to assess the client and determine whether the rhythm is life threatening. More information, including vital signs, should be obtained and the nurse should notify the HCP. A bolus of lidocaine may be prescribed to treat this arrhythmia. This is not a code-type situation unless the client has been determined to be in a life-threatening situation.
The nurse is caring for a client in the coronary care unit when the cardiac monitor reveals ventricular fibrillation and the client becomes unresponsive. The nurse should anticipate which intervention? an I.V. push of digoxin an I.V. line for emergency medications synchronized cardioversion immediate defibrillation
Immediate Defibrilaltion When ventricular fibrillation is verified, the first intervention is defibrillation, which is the only intervention that will terminate this lethal dysrhythmia. Digoxin is not indicated for V-fib. An I.V. will be one of the priorities, but not first. The client would need to have a functional rhythm for synchronized cardioversion to be performed.
Metoprolol is added to the pharmacologic therapy of a diabetic female diagnosed with stage 2 hypertension who has been initially treated with furosemide and ramipril. The nurse should evaluate the client for which expected therapeutic effect? increase in urine output lessening of fatigue decrease in heart rate improvement in blood sugar levels
decrease in heart rate The effect of a beta blocker is a decrease in heart rate, contractility, and afterload, which leads to a decrease in blood pressure. The client at first may have an increase in fatigue when starting the beta blocker. The mechanism of action does not improve blood sugar or urine output.
In presenting a workshop on parameters of cardiac function, which conditions should a nurse list as those most likely to lead to a decrease in preload? - hemorrhage, sepsis, and anaphylaxis - fluid overload, sepsis, and vasodilation - third spacing, heart failure, and diuresis - myocardial infarction, fluid overload, and diuresis
hemorrhage, sepsis, & anaphylaxis Preload is the volume in the left ventricle at the end of diastole. It's also referred to as end-diastolic volume. Preload is reduced by any condition that reduces circulating volume, such as hemorrhage, sepsis, and anaphylaxis. Hemorrhage reduces circulating volume by loss of volume from the intravascular space. Sepsis and anaphylaxis reduce circulating volume by increased capillary permeability. Diuresis, vasodilation, and third spacing also reduce preload. Preload increases with fluid overload and heart failure.
