A client is being treated for heart failure. Labs: Sodium 146, Potassium 2.9, Hemoglobin 10.5, White Blood Cells 12.2 VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4F
What will the nurse do with the digoxin order?
Recheck heart rate in one hour.
Hold the digoxin and call the MD.
Call prescriber and ask for chest x-ray.
Give the digoxin as ordered.
The Correct Answer is B
Choice A reason: This statement is false. The nurse should not delay the administration of digoxin based on the heart rate alone, unless it is below 60 beats per minute. The nurse should also consider the serum potassium level, which is low in this case and increases the risk of digoxin toxicity.
Choice B reason: This statement is true. The nurse should hold the digoxin and call the MD, as the client has a low potassium level, which can potentiate the effects of digoxin and cause arrhythmias, nausea, vomiting, or visual disturbances. The MD may order a serum digoxin level, potassium supplementation, or a dose adjustment.
Choice C reason: This statement is false. The nurse does not need to call the prescriber and ask for a chest x-ray, as this is not relevant to the digoxin order. A chest x-ray may be indicated to assess the severity of heart failure, but it does not affect the decision to administer digoxin.
Choice D reason: This statement is false. The nurse should not give the digoxin as ordered, as the client has a low potassium level, which can increase the risk of digoxin toxicity. The nurse should hold the digoxin and call the MD for further instructions..
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This statement is true. The nurse's best response is to explain that generic medications can have different inactive ingredients, such as fillers, binders, or colors, which may affect how the drug is absorbed, distributed, metabolized, or excreted in the body. This can result in variations in the drug levels and effects in some people. Levothyroxine is a synthetic thyroid hormone that requires precise dosing and monitoring to achieve therapeutic levels and avoid adverse effects. Therefore, the prescriber may prefer the client to take the brand name Synthroid, which has a consistent formulation and quality.
Choice B reason: This statement is false. The nurse should not say that there is less regulation with generic medications, as this is not true. Generic medications are required to meet the same standards of safety, efficacy, and quality as brand name drugs by the Food and Drug Administration (FDA). They must also have the same active ingredient, strength, dosage form, and route of administration as the brand name drug.
Choice C reason: This statement is false. The nurse should not say that it makes no difference, the doctor just gets more money when you buy the brand name, as this is not true and unethical. The doctor does not get any financial benefit from prescribing the brand name drug, and the client may pay more for the brand name drug than the generic one. The doctor may have a valid reason for preferring the brand name drug, such as the client's response, preference, or allergy.
Choice D reason: This statement is false. The nurse should not say that brand name drugs are always better because they are made by major pharmaceutical companies, as this is not true and biased. Brand name drugs are not necessarily better than generic drugs, as they have the same active ingredient and therapeutic effect. However, some brand name drugs may have advantages over generic drugs, such as patent protection, innovation, or formulation.
Correct Answer is A
Explanation
Choice A reason: This statement is true. The nurse should instruct the client to avoid getting up without assistance, as hydralazine can cause orthostatic hypotension, which is a sudden drop in blood pressure when changing positions. This can lead to dizziness, fainting, or falls.
Choice B reason: This statement is false. The nurse does not need to monitor the heart rate with this medication, as hydralazine is not a cardiac drug. Hydralazine is a vasodilator that relaxes the blood vessels and lowers the blood pressure. However, the nurse should monitor the blood pressure and adjust the dose accordingly.
Choice C reason: This statement is false. The nurse does not need to alter the medication with birth control, as hydralazine does not have a significant interaction with hormonal contraceptives. However, the nurse should advise the client to inform the prescriber if they are pregnant or planning to conceive, as hydralazine may have some effects on the fetus.
Choice D reason: This statement is false. The nurse does not need to report a dry cough, as hydralazine does not cause this side effect. A dry cough is more common with angiotensin-converting enzyme (ACE) inhibitors, which are another class of antihypertensive drugs.
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