Digoxin and furosemide were prescribed for a client with chronic heart failure, and the home health nurse is evaluating the client's self-care knowledge of these drugs. Which statement indicates that the client has a good understanding about the use of these drugs?

"I need to notify my healthcare provider if I lose my appetite or get nauseated."

"I should take my furosemide only if I have shortness of breath or swelling in my feet."

"I need to check my blood pressure three times a day."

"If I lose more than one pound in a week, I should hold my next dose of furosemide."

Answer and Explanation

The Correct Answer is A

A. "I need to notify my healthcare provider if I lose my appetite or get nauseated." This statement shows understanding because loss of appetite and nausea can be symptoms of digoxin toxicity or side effects, and it is important to report these symptoms to a healthcare provider. Monitoring for such side effects is crucial when taking digoxin.
B. "I should take my furosemide only if I have shortness of breath or swelling in my feet." This statement is incorrect because furosemide, a diuretic, should be taken according to the prescribed schedule, not based on symptoms. It is used to manage fluid retention and symptoms of heart failure, and its use should not be dependent solely on the presence of symptoms.
C. "I need to check my blood pressure three times a day." While monitoring blood pressure is important, it is not specifically required for patients on digoxin and furosemide unless instructed by a healthcare provider. The focus should be more on monitoring for symptoms of drug side effects and electrolyte imbalances.
D. "If I lose more than one pound in a week, I should hold my next dose of furosemide." Weight loss can be a normal effect of furosemide due to fluid loss, and the decision to hold a dose should be based on specific medical advice and not solely on weight change.

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Correct Answer is D

Explanation

A. Low-density lipoprotein (LDL): Atorvastatin's primary effect is to decrease LDL cholesterol levels. A decrease in LDL levels would indicate the medication is working as intended, not an increase.
B. Prothrombin time (PT): PT is a measure of blood clotting, which is not directly affected by atorvastatin. This value is more relevant for monitoring anticoagulant therapy.

C. Creatine phosphokinase (CK): CK levels can be used to monitor for muscle damage or side effects related to statin use. An increase in CK levels would suggest muscle damage, not the effectiveness of the statin.
D. High-density lipoprotein (HDL): Atorvastatin is a statin medication used to lower cholesterol levels, particularly low-density lipoprotein (LDL) cholesterol, which is a key target in reducing the risk of coronary artery disease (CAD). While the primary goal of atorvastatin is to lower LDL cholesterol, an increase in HDL cholesterol (often termed "good" cholesterol) is also desirable as it can help reduce the risk of CAD. Therefore, an increase in HDL is a positive indicator that the medication is having a beneficial effect.

A. Hematocrit 42% (0.42 volume fraction). B. Positive guaiac of stool. C. Gastric pH 2. D. Hemoglobin 13 g/dl. (8.07 mmol/l)

Correct Answer is B

Explanation

A. Hematocrit 42% (0.42 volume fraction): This value is within the normal range for hematocrit (42% to 52%). Therefore, it does not indicate an immediate concern.
B. Positive guaiac of stool: A positive guaiac test for occult blood in the stool indicates gastrointestinal bleeding. Given the client's history of self-treating with ibuprofen (a nonsteroidal anti-inflammatory drug, NSAID) and his symptoms of fatigue and dizziness, this finding suggests possible gastrointestinal bleeding due to NSAID-induced ulcers or bleeding. This requires immediate reporting to the healthcare provider for further evaluation and intervention.
C. Gastric pH 2: While the gastric pH is on the acidic side, it is within the normal range for gastric acid (1.5 to 3.5). This finding does not necessarily indicate an acute problem by itself.
D. Hemoglobin 13 g/dL (8.07 mmol/L): Although this hemoglobin level is slightly below the normal range for males (14 to 18 g/dL), it is not as critical as a positive guaiac test for stool blood. It might be worth monitoring, but it is not as urgent as addressing potential gastrointestinal bleeding.

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Digoxin and furosemide were prescribed for a client with chronic heart failure, and the home health nurse is evaluating the client's self-care knowledge of these drugs. Which statement indicates that the client has a good understanding about the use of these drugs?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

An increase in which serum lab value indicates to the nurse that a prescription for atorvastatin is having the desired effect for a client at risk for coronary artery disease?

Correct Answer is D

Explanation

Correct Answer is B

Explanation

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