Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?
Report nausea and vomiting to your health care provider.
Auditory hallucinations are common adverse effects.
Decrease the amount of high-potassium foods you eat.
Omit your dose of digoxin if your pulse is 70.
The Correct Answer is A
Choice A reason: This is the correct instruction by the nurse. Nausea and vomiting are signs of digoxin toxicity, which can be life-threatening. The patient should report these symptoms to their health care provider as soon as possible and have their digoxin level checked.
Choice B reason: This is not a correct instruction by the nurse. Auditory hallucinations are not common adverse effects of digoxin. They are more likely to occur with other drugs, such as antipsychotics or opioids.
Choice C reason: This is not a correct instruction by the nurse. Decreasing the amount of high-potassium foods can increase the risk of digoxin toxicity, as potassium competes with digoxin for binding sites on the cardiac cells. The patient should maintain a normal potassium intake and avoid sudden changes in their diet.
Choice D reason: This is not a correct instruction by the nurse. Omitting the dose of digoxin if the pulse is 70 can lead to underdosing and ineffective treatment of heart failure. The patient should only omit the dose of digoxin if their pulse is below 60, as this indicates bradycardia, which is another sign of digoxin toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the correct statement. Non-selective beta-adrenergic blockers can interfere with the signs and symptoms of hypoglycemia (low blood sugar), such as tachycardia, tremors, and sweating. They can also impair the glucose metabolism and insulin secretion in the body. Therefore, patients with diabetes who take non-selective beta-adrenergic blockers need to monitor their blood glucose levels closely and adjust their insulin or oral hypoglycemic agents accordingly.
Choice B reason: This is not a correct statement. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, do not interact with non-selective beta-adrenergic blockers. However, they can reduce the effectiveness of other antihypertensive medications, such as diuretics or ACE inhibitors, by causing fluid retention and decreasing renal blood flow.
Choice C reason: This is not a correct statement. Non-selective beta-adrenergic blockers have a rapid onset of action and can lower the blood pressure within hours of administration. Therefore, patients do not need to wait for a few weeks to see if their dosage is effective. However, they may need periodic follow-up visits to monitor their blood pressure, heart rate, and other vital signs.
Choice D reason: This is not a correct statement. Dizziness is a common side effect of non-selective beta-adrenergic blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this does not mean that the patient should stop taking the medication, as this can cause rebound hypertension and other complications. Instead, the patient should rise slowly from a sitting or lying position, drink plenty of fluids, and report any severe or persistent dizziness to their health care provider.
Correct Answer is D
Explanation
Choice A reason: Cardiac output has not fallen below normal levels. Cardiac output is the amount of blood pumped by the heart per minute. It is affected by the heart rate and the stroke volume. Angina pectoris does not directly affect the cardiac output, but it can reduce the stroke volume due to impaired ventricular filling.
Choice B reason: The vagus nerve is not stimulated. The vagus nerve is a cranial nerve that innervates the heart and other organs. It is part of the parasympathetic nervous system, which slows down the heart rate and lowers the blood pressure. Angina pectoris does not activate the vagus nerve, but it can trigger the sympathetic nervous system, which increases the heart rate and blood pressure.
Choice C reason: Myocardial stretch has not exceeded the upper limits. Myocardial stretch is the degree of tension or load on the cardiac muscle fibers. It is determined by the end-diastolic volume, which is the amount of blood in the ventricle at the end of relaxation. Angina pectoris does not cause excessive myocardial stretch, but it can impair the myocardial contractility due to ischemia.
Choice D reason: The myocardial oxygen supply has fallen below demand. This is the main cause of angina pectoris. It occurs when the coronary arteries, which supply blood and oxygen to the heart muscle, are narrowed or blocked by atherosclerosis or spasm. This creates an imbalance between the oxygen demand of the heart, which increases during exertion, and the oxygen supply, which is reduced by the obstruction.
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