cardiac notes

Question 1

treats unstable angina

Answer 1

nitroglycerin

Question 2

treats stable angina

Answer 2

beta blocker

slows HR

Question 3

you DO NOT give beta blocker to patients with ___.

Answer 3

1st degree heart block

Question 4

treats vasospatic angina

Answer 4

calcium channel blockers

dilate arterial smooth muscle, gets more blood to the heart

Question 5

what of the major AE of calcium channel blockers is?

Answer 5

reflex tachycardia

Question 6

how many times do you dose ace inhibitors?

Answer 6

3 times a day. 1 hr before food.

Question 7

major AE of ace inhibitors is?

Answer 7

dry nonproductive cough

hyperkalemia

Question 8

what are the normal value for potassium?

Answer 8

3.5 to 5.0

Question 9

AE for diuretic (lasix)

Answer 9

electrolyte imbalance

–ototoxicity

Question 10

what drug treats heart failure has a very narrow theupuetic range?

Answer 10

digoxin

Question 11

what is the range for digoxin ? (serum levels)

Answer 11

0.5 ng/ml-2 ng/ml

Question 12

_ is the process by which the dose of digoxin is incresed until tissues become saturated with the medication and the symptoms of HF decreases.

Answer 12

digitalization

Question 13

one of the significant thing to observe for dig toxicity is?

Answer 13

patient seeing yellow-green or white halos around objects, diplopia, blurred vision

Question 14

for severe digoxin toxicity, an anitdote ____ is administered IV to neutralize digoxin

Answer 14

digibind

Question 15

major AE for procainamide?

Answer 15

systemic lups syndrome

swelling, enlargement of joints, fever, develop butterfly rash

Question 16

dopamine low does effects____ and the high doses effects___

Answer 16

renal vessels to dilate ; helps patients in renal failure

high doses— treats shock! help contractions of the heart but can also cause vasoconstriction

Question 17

big ae for vasopresssin?

Answer 17

water intoxication

Question 18

A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is complaining of anorexia. The health care provider prescribes determination of the serum digoxin level to rule out digoxin toxicity. The nurse checks the results, knowing that which value is the therapeutic serum level (range) for digoxin?

1. 0.5 to 2 ng/mL
2. 1.2 to 2.8 ng/mL
3. 3.0 to 5.0 ng/mL
4. 3.5 to 5.5 ng/mL

Answer 18

1. 0.5 to 2 ng/mL

Question 19

A client is being treated with procainamide for a cardiac dysrhythmia. Following intravenous administration of the medication, the client complains of dizziness. What intervention should the nurse take first?

1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerin tablets.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client’s apical pulse and obtain a blood pressure.

Answer 19

4. Auscultate the client’s apical pulse and obtain a blood pressure.

Question 20

The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply.

1. Tremors
2. Diarrhea
3. Irritability
4. Blurred vision
5. Nausea and vomiting

Answer 20

◦2. Diarrhea
◦4. Blurred vision
◦5. Nausea and vomiting

Question 21

Prior to administering a client’s daily dose of digoxin, the nurse reviews the client’s laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.1 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity?

1. Serum calcium level
2. Serum potassium level
3. Serum creatinine level
4. Serum magnesium level

Answer 21

4. Serum magnesium level

Question 22

The home care nurse has given instructions to a client who is beginning therapy with digoxin (Lanoxin). The nurse determines a need for further teaching of the instructions if the client makes which statement?

1. “If I miss a dose, I should just take two the next day.”
2. “I shouldn’t change brands without asking the health care provider first.”
3. “I should call the health care provider if my daily pulse rate is under 60 or over 100.”
4. “The pills should be kept in their original container so they don’t get mixed up with my other medicines.”

Answer 22

1. “If I miss a dose, I should just take two the next day.”

Question 23

A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement?

1. “I need to wait until the next day to apply a new patch if it falls off.”
2. “I need to alternate daily dosage times to prevent tolerance to the medication.”
3. “I need to place the patch in the area of a skin fold to promote better adherence.”
4. “I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed.”

Answer 23

4. “I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed.”

Question 24

A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition?

1. An expected medication side effect
2. An allergic reaction to nitroglycerin
3. An early sign of tolerance to the medication
4. A warning that the medication should not be used again

Answer 24

1. An expected medication side effect

Question 25

Lisinopril (Prinivil) has been prescribed for a client. What should the nurse instruct the client to do? 1. Take the medication with food only. 2. Discontinue the medication if nausea occurs. 3. Rise slowly from a reclining to a sitting position. 4. Expect to note a full therapeutic effect immediately.

Answer 25

3. Rise slowly from a reclining to a sitting position.

Question 26

A client receiving total parenteral nutrition (TPN) has a history of heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect from this medication? 1. Sodium 2. Glucose 3. Potassium 4. Magnesium

Answer 26

3. Potassium

Question 27

A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect? 1. Sudden increase in appetite 2. Weight gain of 2 to 3 lb in a few days 3. Increased urine output during the day 4. Cough accompanied by other signs of respiratory infection

Answer 27

2. Weight gain of 2 to 3 lb in a few days

Question 28

A client with pulmonary edema has a prescription to receive morphine sulfate intravenously. The nurse should determine that the client is experiencing an intended effect of the medication as indicated by which assessment finding? 1. Increased pulse rate 2. Relief of apprehension 3. Decreased urine output 4. Increased blood pressure

Answer 28

2. Relief of apprehension

Question 29

A health care provider writes a prescription for lisinopril (Zestril) for a hospitalized client. The nurse caring for the client determines that the medication has been prescribed to treat which disorder? 1. Hypertension 2. Immune disorder 3. Venous insufficiency 4. Gastroesophageal reflux disorder

Answer 29

1. Hypertension

Question 30

A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? 1. The medication may need to be changed. 2. The cough must be the start of a respiratory infection. 3. The medication needs to be taken with large amounts of water to prevent the cough. 4. This sometimes happens, and the client will need to take a cough medication with each dose of medication.

Answer 30

1.The medication may need to be changed.

Question 31

The home care nurse visits a client with a diagnosis of unstable angina. The client is taking acetylsalicylic acid (aspirin) on a daily basis to reduce the risk of myocardial infarction (MI). Which medication dose would the nurse expect the client to be taking? 1. 300 to 325 mg daily 2. 650 to 700 mg daily 3. 1.3 g daily 4. 3 g daily

Answer 31

1. 300 to 325 mg daily

Question 32

Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with angina, and the client asks the nurse how the medication will help. The nurse responds that this medication has been prescribed for which purpose? 1. Reduce pain. 2. Reduce inflammation. 3. Inhibit platelet aggregation. 4. Maintain a normal body temperature.

Answer 32

3. Inhibit platelet aggregation.

Question 33

A client is seen in the clinic complaining of anorexia and nausea. The health care provider suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity? 1. Edema 2. Chest pain 3. Constipation 4. Photophobia

Answer 33

4. Photophobia

Question 34

The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN use if chest pain occurs. Which client statement indicates an understanding of this medication? 1. "It's best to keep this medication in a shirt pocket close to the body." 2. "I need to discard unused tablets 6 to 9 months after the bottle is opened." 3. "I will avoid using the medication until the chest pain actually begins and gets worse." 4. "I can take aspirin for any headache that occurs when I first start taking the nitroglycerin."

Answer 34

2. "I need to discard unused tablets 6 to 9 months after the bottle is opened."

Question 35

A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates? 1. "Do not remove the patches." 2. "Have a 12-hour ‘no-nitrate' time." 3. "Ensure a 24-hour ‘no-nitrate' time." 4. "Keep nitrates on 24 hours, then off 24 hours."

Answer 35

2. "Have a 12-hour ‘no-nitrate' time."

Question 36

A client with nausea and bradycardia is admitted to a medical unit. The family hands a nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin (Lanoxin). A family member states, "That health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse? 1. "Don't worry about this. I'll take care of everything." 2. "You are concerned your loved one receives the best care." 3. "You're right! I've never seen them put pills in an envelope." 4. "I think you're wrong. That health care provider (HCP) has been in practice more than 30 years."

Answer 36

2. "You are concerned your loved one receives the best care."

Question 37

A home health care nurse is visiting an older client at home. Furosemide (Lasix) is prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching? 1. "I will sit up slowly before standing each morning." 2. "I will take my medication every morning with breakfast." 3. "I need to drink lots of coffee and tea to keep myself healthy." 4. "I will call my health care provider (HCP) if my ankles swell or my rings get tight."

Answer 37

3. "I need to drink lots of coffee and tea to keep myself healthy."

Question 38

The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 1. Fluid overload 2. Peripheral vasoconstriction 3. Inability to perform self-care 4. Inability to discriminate hot or cold sensations

Answer 38

2. Peripheral vasoconstriction

Question 39

The nurse has completed medication administration that included a nitroglycerin. Within minutes, the client is complaining of a headache. Which is the priority nursing action at this time? 1. Evaluate pupil response. 2. Place the client on the left side. 3. Administer the prescribed analgesic. 4. Notify the health care provider (HCP) immediately.

Answer 39

3.. Administer the prescribed analgesic.

Question 40

The nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to check before administering this medication? 1. Blood urea nitrogen 2. Cholesterol level 3. Potassium level 4. Creatinine level

Answer 40

3. Potassium level

Question 41

104. The nurse is preparing to administer furosemide (Lasix) 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period? 1. 10 seconds 2. 30 seconds 3. 1 minute 4. 5 minutes

Answer 41

3. 1 minute

Question 42

A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? 1. Count the radial and carotid pulses every morning. 2. Check the blood pressure every morning and evening. 3. Stop taking the medication if the pulse is faster than 100 beats/min. 4. Withhold the medication, and call the health care provider if the pulse is slower than 60 beats/min.

Answer 42

4. Withhold the medication, and call the health care provider if the pulse is slower than 60 beats/min.

Question 43

A client with angina pectoris is experiencing chest pain that radiates down the left arm. The nurse administers a sublingual nitroglycerin tablet to the client. The client's pain is unrelieved, and the nurse determines that the client needs another nitroglycerin tablet. Which vital sign is the most important for the nurse to check before administering the medication? 1. Temperature 2. Respirations 3. Blood pressure 4. Radial pulse rate

Answer 43

3. Blood pressure

Question 44

A client with heart disease is taking digoxin (Lanoxin) and complains of having no appetite, and experiencing diarrhea and blurry vision. The nurse notes that the client's serum potassium (K) level is 3.0 mEq/L. Based on analysis of the data, what might the nurse expect to note when reviewing the digoxin level results? 1. Digoxin level of 1.8 ng/mL 2. Digoxin level higher than 2 ng/mL 3. Digoxin level lower than 0.5 ng/mL 4. Digoxin level of 0 ng/mL because of diarrhea

Answer 44

2. Digoxin level higher than 2 ng/mL

Question 45

The nurse has a prescription to give a client a scheduled dose of digoxin (Lanoxin). Prior to administering the medication, the nurse should assess for which manifestations that could indicate digoxin toxicity? 1. Dyspnea, edema, and palpitations 2. Chest pain, hypotension, and paresthesias 3. Constipation, dry mouth, and sleep disorder 4. Double vision, loss of appetite, and nausea

Answer 45

4. Double vision, loss of appetite, and nausea

Question 46

A hospitalized client with a history of angina pectoris complains of substernal chest pain. The nurse checks the client's blood pressure and administers nitroglycerin, gr 1/4 sublingually. Five minutes later, the client is still experiencing chest pain. If the blood pressure remains stable, the nurse should take which action next? 1. Administer another nitroglycerin tablet. 2. Administer 10 L of oxygen via nasal cannula. 3. Call for a 12-lead electrocardiogram (ECG) to be performed. 4. Wait an additional 5 minutes, and then give a second nitroglycerin tablet

Answer 46

1. Administer another nitroglycerin tablet.

Question 47

The nurse is caring for a child with heart failure (HF). The nurse provides instructions to the mother regarding the procedure for administration of the prescribed digoxin (Lanoxin). Which statement by the mother indicates a need for further teaching? 1. "I will make sure to mix the medication with food." 2. "I need to take the child's pulse before administering the medication." 3. "If more than one dose is missed, I need to call the health care provider." 4. "If the child vomits after being given the medication, I should not repeat the dose."

Answer 47

1. "I will make sure to mix the medication with food."