The nurse would contact the prescriber for safety concerns about using carvedilol in which of the following clients?
A 60 year old woman with cardiac dysrhythmias post myocardial infarction. Her HR is 39 & irregular, BP 147/65
A 55-year-old woman with HTN due to renal failure from chronic pyleonephritis. HR 92. BP 145/72
A 78-year-old man with a history of hyperlipidemia & cardiac dysfunction. He is in 3rd degree heart block. HR 42. BP 92/65
A 49-year-old male, BMI 36, history of type 2 diabetes & HTN. HR 105, BP 158/92
The Correct Answer is C
A. A 60-year-old woman with cardiac dysrhythmias post myocardial infarction. Her HR is 39 & irregular, BP 147/65: Although her heart rate is low, carvedilol is commonly used post-MI to reduce mortality, especially in patients with dysrhythmias. However, caution is warranted, and dosage adjustments or withholding may be necessary due to bradycardia.
B. A 55-year-old woman with HTN due to renal failure from chronic pyelonephritis. HR 92. BP 145/72: This client has stable vitals, and carvedilol can be safely used to help manage hypertension. Renal impairment requires monitoring, but it is not a contraindication if renal function is closely followed.
C. A 78-year-old man with a history of hyperlipidemia & cardiac dysfunction. He is in 3rd degree heart block. HR 42. BP 92/65: Carvedilol is contraindicated in clients with 2nd or 3rd degree heart block without a functioning pacemaker. It can worsen bradycardia and conduction delays, making its use unsafe in this client without rhythm control support.
D. A 49-year-old male, BMI 36, history of type 2 diabetes & HTN. HR 105, BP 158/92: This client is hypertensive and tachycardic, both of which carvedilol can help manage. Although diabetes requires careful monitoring for hypoglycemia, there is no contraindication in this scenario.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Dilated: Peripartum cardiomyopathy is a form of dilated cardiomyopathy that can occur during the last month of pregnancy or within five months after delivery. It is characterized by ventricular dilation and impaired systolic function, leading to signs of heart failure in previously healthy women.
B. Restrictive: Restrictive cardiomyopathy is a rare form that involves impaired ventricular filling due to stiffened myocardial walls. It is typically associated with infiltrative diseases like amyloidosis or sarcoidosis, not with pregnancy or the postpartum period.
C. Hypertrophic: Hypertrophic cardiomyopathy is usually genetic and involves thickened ventricular walls, especially the interventricular septum. It is not linked to childbirth and tends to present earlier in life with symptoms like syncope or sudden cardiac death in young athletes.
D. Myocarditis: Myocarditis involves inflammation of the heart muscle due to infection or autoimmune causes. Although it can occur postpartum, it is not specifically associated with childbirth like peripartum cardiomyopathy, which is a distinct clinical entity.
Correct Answer is ["2.5"]
Explanation
Convert the available dose from grams (Gm) to milligrams (mg):
0.15 Gm × 1000 mg/Gm = 150 mg
Desired dose = 75 mg
Available dose = 150 mg
Volume = 5 mL
Formula:
Volume to administer = Desired dose / Available dose × Volume
= 75 mg / 150 mg × 5 mL
= 0.5 × 5 mL
Volume to administer = 2.5 mL
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