A nurse is preparing to administer digoxin to a client who has left-sided heart failure.
Which of the following clinical manifestations should the nurse expect to see in this client? (Select all that apply.).

Gastrointestinal bloating.

Jugular vein distention.

Tachycardia.

Orthopnea.

Dyspnea.

Answer and Explanation

Correct Answer : C,D,E

Choice A rationale:

Gastrointestinal bloating is not a typical clinical manifestation of left-sided heart failure. Left-sided heart failure primarily affects the pulmonary circulation, leading to symptoms such as dyspnea and orthopnea, but not gastrointestinal symptoms.

Choice B rationale:

Jugular vein distention is more commonly associated with right-sided heart failure. In left-sided heart failure, the congestion typically occurs in the pulmonary circulation, leading to respiratory symptoms, whereas jugular vein distention is a sign of elevated central venous pressure often seen in right-sided heart failure.

Choice C rationale:

Tachycardia is a common clinical manifestation of left-sided heart failure. As the heart struggles to pump blood effectively, it compensates by increasing the heart rate to maintain cardiac output.

Choice D rationale:

Orthopnea is a classic symptom of left-sided heart failure. Clients with left-sided heart failure often experience difficulty breathing when lying flat and find relief when sitting upright. This is due to the redistribution of blood in the lungs when changing positions.

Choice E rationale:

Dyspnea is another hallmark symptom of left-sided heart failure. It is caused by the accumulation of fluid in the lungs (pulmonary edema) due to the impaired ability of the left ventricle to effectively pump blood, leading to congestion in the pulmonary circulation.

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Correct Answer is B

Explanation

Choice A rationale:
A client who takes glyburide for type 2 diabetes mellitus is not at significant risk for developing digoxin toxicity. Glyburide is an antidiabetic medication and does not interact directly with digoxin.

Choice B rationale: Furosemide, a loop diuretic, can cause electrolyte imbalances such as hypokalemia (normal potassium levels: 3.5 to 5.0 mEq/L) and hypomagnesemia (normal magnesium levels: 1.7 to 2.2 mg/dL). These imbalances increase the sensitivity to digoxin and the risk of toxicity. Digoxin toxicity is associated with symptoms like nausea, vomiting, and arrhythmias. Furosemide's impact on electrolytes makes it a significant risk factor for digoxin toxicity.

Choice C rationale: Cimetidine, a histamine H2 receptor antagonist, can inhibit the metabolism of certain drugs by affecting liver enzymes. However, it does not significantly alter digoxin levels or increase the risk of toxicity. Normal liver enzyme levels include ALT (7 to 56 U/L) and AST (10 to 40 U/L). While cimetidine may interact with other medications, its effect on digoxin is minimal.

Choice D rationale:
A client who takes azelastine for allergic rhinitis is not at significant risk for developing digoxin toxicity. Azelastine is an antihistamine and does not interact directly with digoxin.

A. Extreme thirst. B. Weak, irregular pulse. C. Hyperactive bowel sounds. D. Hyperactive reflexes.

Correct Answer is B

Explanation

Choice A rationale:

Extreme thirst is not a typical finding in a client with hypokalemia. Hypokalemia is an electrolyte imbalance that can lead to symptoms like weakness and irregular heartbeats, but extreme thirst is not a direct result of low potassium levels.

Choice B rationale:

"Weak, irregular pulse" is the correct response. Hypokalemia can lead to cardiac arrhythmias, which may manifest as a weak, irregular pulse. Potassium plays a crucial role in maintaining the electrical activity of the heart, and low levels can disrupt normal heart rhythms.

Choice C rationale:

Hyperactive bowel sounds are not typically associated with hypokalemia. Instead, you might expect diminished or absent bowel sounds in severe cases due to muscle weakness.

Choice D rationale:

Hyperactive reflexes are not typically associated with hypokalemia. Instead, hypokalemia can lead to muscle weakness and potentially even paralysis in severe cases.

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A nurse is preparing to administer digoxin to a client who has left-sided heart failure.Which of the following clinical manifestations should the nurse expect to see in this client? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in a provider's office is reviewing the laboratory results of four clients who take digoxin. Which of the following clients is at risk for developing digoxin toxicity?

Correct Answer is B

Explanation

A nurse is collecting data from a client who has hypokalemia as a result of nausea, vomiting, and diarrhea.Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

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A nurse is reinforcing discharge teaching with a client about dietary sources of potassium. Which of the following statements by the client indicates an understanding of the teaching?

A nurse is preparing to administer digoxin to a client who has left-sided heart failure.
Which of the following clinical manifestations should the nurse expect to see in this client? (Select all that apply.).