A nurse is discussing the use of docusate sodium (Colace) with a client who is recovering from a non-ST elevation myocardial infarction (NSTEMI). What is the rationale for administering this medication during the recovery from a myocardial infarction?
Treats hyperlipidemia to reduce the risk of new plaques
Prevents the formation of clots to reduce the risk of stroke
Prevents vagal stimulation to reduce e risk of dysrhythmias
Removes excess sodium to reduce the risk of hypertension
The Correct Answer is C
A. This statement refers to medications like statins (e.g., rosuvastatin, atorvastatin) which are used to lower cholesterol levels and reduce the risk of atherosclerosis progression. Docusate sodium does not treat hyperlipidemia or affect plaque formation directly.
B. This refers to anticoagulant medications (e.g., heparin, warfarin, direct oral anticoagulants) which are used to prevent clot formation and reduce the risk of thromboembolic events such as stroke. Docusate sodium does not have anticoagulant properties.
C. After a myocardial infarction (MI), especially in the early recovery phase, vagal stimulation can exacerbate bradycardia or contribute to dysrhythmias. Stool softeners like docusate sodium help prevent constipation, which can stimulate the vagus nerve during straining, potentially leading to vagally mediated dysrhythmias such as bradycardia or atrioventricular blocks.
D. Diuretics (e.g., furosemide, hydrochlorothiazide) are used to reduce fluid retention and lower blood pressure by increasing urine output. Docusate sodium does not remove excess sodium or affect blood pressure regulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Fluticasone is an inhaled corticosteroid used primarily for maintenance therapy in COPD and asthma. It helps reduce airway inflammation and prevent exacerbations but is not used for immediate relief of acute symptoms such as bronchospasm or sudden shortness of breath.
B. Fluticasone, like other corticosteroids delivered by inhalation, can increase the risk of oral thrush (candidiasis) due to its local immunosuppressive effects in the mouth. It's important for clients to monitor their oral cavity regularly for signs such as white patches or soreness. Including this instruction is crucial to detect thrush early so that appropriate treatment can be initiated if necessary.
C. Monitoring heart rate is not specifically necessary before each dose of fluticasone. Fluticasone is not known to cause significant cardiovascular effects such as changes in heart rate. Heart rate monitoring may be more relevant for medications that can affect cardiovascular function or in clients with pre- existing cardiac conditions.
D. Fluticasone should be used regularly as prescribed for maintenance therapy to control airway inflammation and prevent exacerbations in COPD. Skipping doses, even if symptoms are not present, can lead to inadequate control of the disease and potential worsening of symptoms over time.
Correct Answer is C
Explanation
A. This function is typically managed by medications such as beta-blockers or calcium channel blockers, which help reduce heart rate and myocardial oxygen demand. Rosuvastatin does not directly affect heart rate or myocardial oxygen demand.
B. Medications like aspirin or other antiplatelet agents are used to inhibit platelet aggregation and reduce the risk of thrombus formation. Rosuvastatin is not primarily indicated for this purpose.
C. This is the correct rationale for prescribing rosuvastatin in a client with chronic stable angina. High LDL cholesterol levels contribute to the development and progression of atherosclerosis, which narrows coronary arteries and leads to angina. By lowering LDL cholesterol levels, rosuvastatin helps slow down the progression of atherosclerosis and reduces the risk of cardiovascular events, including angina.
D. Acute episodes of angina are typically managed with short-acting nitrates or other medications that dilate coronary arteries to improve blood flow to the heart muscle. Rosuvastatin does not provide immediate relief of angina symptoms.
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