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 A

Explanation

A. Immediately after completion of the IV dose and 30 minutes before the next administration of the medication: This timing is correct for monitoring vancomycin levels. The peak level is typically measured immediately after the completion of the infusion (though peak levels are less commonly required for vancomycin), and the trough level is measured just before the next dose is due, 30 minutes before administration. This approach helps in evaluating the medication's efficacy and safety.
B. One hour after completion of the IV dose and one hour before the next administration of the medication: This timing is not ideal. The peak level for vancomycin is usually measured immediately after the dose rather than one hour later. Trough levels are measured closer to the next dose, typically 30 minutes before the next dose.
C. Two hours after completion of the IV dose and two hours before the next administration of the medication: Measuring levels two hours after the dose completion is too late for a peak level. The trough level should be measured closer to the next dose, generally 30 minutes before the next administration.
D. Thirty minutes into the administration of the IV dose and 30 minutes before the next administration of the medication: Measuring the level 30 minutes into the infusion is not appropriate for peak levels, which are typically measured.

A. Restlessness. B. Decreased appetite. C. Intolerance to cold. D. Constipation.

Correct Answer is A

Explanation

A. Restlessness: Restlessness is a sign of excessive levothyroxine sodium, which can lead to symptoms of hyperthyroidism. Other signs include palpitations, nervousness, and insomnia. Overmedication can accelerate metabolism and cause these symptoms.
B. Decreased appetite: Decreased appetite is not typically associated with overmedication of levothyroxine. Instead, a decreased appetite might be related to other conditions or medications but is not a primary indicator of excessive thyroid hormone.
C. Intolerance to cold: Intolerance to cold is more indicative of hypothyroidism or insufficient dosing of levothyroxine rather than overmedication. Excessive levothyroxine usually causes symptoms of hyperthyroidism, such as heat intolerance.
D. Constipation: Constipation is more commonly associated with hypothyroidism or insufficient levothyroxine dosing. Overmedication generally leads to symptoms like diarrhea rather than constipation.

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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?

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Naxlex Comprehensive Predictor Exams

A client is receiving IV vancomycin and the nurse plans to draw blood for a peak and trough to determine the serum level of the medication. Which collection times provide the best determination of these levels?

Correct Answer is A

Explanation

Levothyroxine sodium is prescribed for a client with hypothyroidism. The nurse should instruct the client to report which symptom because it indicates that the client is taking too much levothyroxine sodium.

Correct Answer is A

Explanation

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