A patient asked the nurse what cardiac glycosides do to improve his condition.
What is the nurse's best response?

Choice A rationale

This choice is correct. The side effects of paroxetine, including headaches, nervousness, and poor appetite, are common during the initial weeks of treatment and often decrease over time as the patient’s body adjusts to the medication. Reassuring the patient helps them continue the treatment without undue anxiety about these side effects, which are typically transient and manageable.

Choice B rationale

This choice is incorrect. Abruptly stopping paroxetine without consulting a healthcare provider is not recommended because it can lead to withdrawal symptoms and a possible relapse of depression or anxiety. The patient should only discontinue the medication under the guidance of a healthcare provider, who may suggest a gradual tapering off process to minimize withdrawal symptoms.

Choice C rationale

This choice is partially correct. Taking paroxetine with food can help mitigate some gastrointestinal side effects, such as nausea. However, it does not directly address headaches, nervousness, or poor appetite. Although taking the medication with food is a useful tip, it is not the most comprehensive advice for this particular situation.

Choice D rationale

This choice is incorrect. While adjusting the dose may be an option, it is premature to suggest this after only two weeks of treatment. The patient’s body may still be adjusting to the medication, and many side effects diminish with time. The decision to change the dosage should be made by the healthcare provider based on a thorough evaluation of the patient’s response to the treatment.

Choice A rationale

Cardiac glycosides are not known for increasing heart rate. Instead, they tend to decrease heart rate by enhancing vagal tone and increasing the refractory period of the atrioventricular node, which helps in controlling heart rate, especially in atrial fibrillation.

Choice B rationale

Cardiac glycosides actually increase the force of myocardial contractions. They inhibit the sodium-potassium ATPase pump, which leads to an increase in intracellular sodium and calcium levels in the myocardial cells, thus increasing the force of contraction.

Choice C rationale

Cardiac glycosides do not significantly decrease conduction velocity. They primarily affect the contractility and heart rate but their influence on conduction velocity is relatively mild.

Choice D rationale

Cardiac glycosides improve renal blood flow and increase urine output by increasing the cardiac output and reducing the activation of the renin-angiotensin-aldosterone system. This helps in relieving symptoms of heart failure.