A client is admitted for treatment of pulmonary edema. Which medication will the nurse administer to improve the force of cardiac contraction for this client?

Warfarin

Enalapril

Bumetanide

Dobutamine

Answer and Explanation

The Correct Answer is D

a. Warfarin: Warfarin is an anticoagulant medication used to prevent blood clot formation. While it is commonly prescribed for certain cardiac conditions such as atrial fibrillation or mechanical heart valves to prevent thromboembolic events, it does not directly improve the force of cardiac contraction. Therefore, warfarin is not the appropriate medication for improving cardiac contraction in a client with pulmonary edema.

b. Enalapril: Enalapril is an angiotensin-converting enzyme (ACE) inhibitor used to manage hypertension and heart failure. While ACE inhibitors can help reduce preload and afterload on the heart, leading to improved cardiac function over time, they do not directly improve the force of cardiac contraction acutely. Therefore, enalapril is not the appropriate medication for improving cardiac contraction in a client with pulmonary edema.

c. Bumetanide: Bumetanide is a loop diuretic medication used to promote diuresis and reduce fluid overload in conditions such as heart failure and pulmonary edema. While reducing fluid overload can indirectly improve cardiac function by reducing preload on the heart, loop diuretics do not directly improve the force of cardiac contraction.

d. Dobutamine: Dobutamine is a positive inotropic medication that directly stimulates beta-1 adrenergic receptors in the heart, leading to increased myocardial contractility (force of cardiac contraction) and improved cardiac output. It is commonly used in the treatment of acute heart failure, including pulmonary edema, to enhance cardiac function and reduce symptoms of congestion.

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Correct Answer is ["A","B","C","E"]

Explanation

a. Abdominal distension: Abdominal distension can occur in cases of severe digoxin toxicity due to its effects on gastrointestinal motility. Digoxin toxicity can lead to nausea, vomiting, and abdominal discomfort, which can contribute to abdominal distension. Therefore, abdominal distension is consistent with digoxin toxicity.

b. Digoxin level 4.1 ng/ml (0.8-2.0ng/ml): Digoxin levels above the therapeutic range (0.8-2.0 ng/ml) indicate digoxin toxicity. A level of 4.1 ng/ml is significantly higher than the therapeutic range, confirming digoxin toxicity.

c. Blurry vision: Blurry vision is a common symptom of digoxin toxicity. Visual disturbances, such as yellow or green halos around lights or changes in color vision, can occur due to digoxin's effects on the optic nerve. Therefore, blurry vision is consistent with digoxin toxicity.

d. Increased platelet level: Digoxin toxicity typically does not cause an increase in platelet levels. Instead, it can lead to thrombocytopenia (a decrease in platelet levels) due to its effects on bone marrow function. Therefore, increased platelet levels are not consistent with digoxin toxicity.

e. Arrhythmia: Digoxin toxicity can cause various cardiac arrhythmias, including atrial tachycardia, atrioventricular block, and ventricular tachycardia. Therefore, experiencing arrhythmias is consistent with digoxin toxicity.

A. Assess level of consciousness B. Monitor serum sodium C. Check skin turgor D. Administer diuretics

Correct Answer is A

Explanation

a. Assess level of consciousness: Respiratory acidosis in COPD patients can lead to hypercapnia (elevated carbon dioxide levels), which may result in altered mental status, confusion, or decreased level of consciousness due to respiratory depression. Assessing the level of consciousness is important to monitor for signs of worsening respiratory distress or impending respiratory failure.

b. Monitor serum sodium: COPD patients with respiratory acidosis may retain carbon dioxide, leading to respiratory compensation by the kidneys through increased retention of bicarbonate ions. This retention of bicarbonate can result in metabolic alkalosis and potentially affect electrolyte balance, including sodium levels. Monitoring serum sodium levels is essential to detect any electrolyte imbalances that may occur as a result of respiratory acidosis and its compensatory mechanisms.

c. Check skin turgor: While checking skin turgor is a valuable assessment for hydration status, it may not be directly related to respiratory acidosis in COPD. However, it's still important to assess hydration status in COPD patients, especially those with exacerbations, as dehydration can exacerbate respiratory symptoms.

d. Administer diuretics: Diuretics are not typically indicated in the management of respiratory acidosis in COPD. In fact, diuretics can worsen respiratory acidosis by potentially causing volume depletion and further reducing effective gas exchange in already compromised lungs. Diuretics may be used cautiously in COPD patients with concomitant heart failure or volume overload, but their use should be carefully monitored and individualized.

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A client is admitted for treatment of pulmonary edema. Which medication will the nurse administer to improve the force of cardiac contraction for this client?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with digoxin toxicity. Which findings are consistent with this diagnosis? Select all that apply.

Correct Answer is ["A","B","C","E"]

Explanation

Which intervention would the nurse include in the plan of care for a client with COPD and respiratory acidosis?

Correct Answer is A

Explanation

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