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A patient about to receive his morning dose of digoxin has an apical
pulse of 70 beats per minute. What will the nurse do?
A. Administer the dose.
B. Administer the dose and notify the physician.
C. Check the radial pulse for 1 full minute.
D. Withhold the dose and notify the
ANS: A. Administer the dose.
In assessing a patient before administration of a cardiac glycoside,
the nurse knows that what condition can predispose a patient to
digitalis toxicity?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hypernatremia
ANS: A. Hypokalemia; control ventricular response to atrial
fibrillation and a derived from foxglove. Digoxin is the only available
cardiac glycoside---positive inotropic---inhibits sodium potassium
pump (adenosine tripphophatase) Sodium and calcium rise.
Cholinergic stimulation via the vagus nerve of Parasympathetic
,nervous system. ---Negative chronotropic---Negative Dromotropic
effect
While assessing a patient who is receiving intravenous digitalis, the
nurse recognizes that the drug has a negative chronotropic effect.
How would this drug effect be evident in the patient?
A. Increased heart rate
B. Decreased heart rate
C. Decreased conduction
D. Increased ectopic beats
ANS: B. Decreased heart rate
A patient has been taking digoxin at home but has taken an
accidental overdose and has developed toxicity. He has been
admitted to the telemetry unit where the physician has ordered
digoxin immune Fab (Digibind). The patient asks the nurse why the
medication is ordered. What is the nurse's best response?
A. "It works faster than digoxin."
B. "It is safer than digoxin and can be taken orally."
C. "It helps to convert the irregular heart rhythm to a more normal
rhythm."
D. "This drug is an antidote to digoxin and will help to lower the blood
levels."
ANS: D. "This drug is an antidote to digoxin and will help to lower the
blood levels." (severe bradycardia, advanced heart block,
ventricularr tachycardia, fibrillation, and hyperkalemia); available in
parental form. Clinical signs and symptoms are monitored NOT
serum levels----used for systolic heart failure and atrial fibrillation.
5. A patient has been placed on a milrinone infusion as part of the
therapy for end-stage heart failure. What risks involved with this
drug will the nurse keep in mind while assessing this patient during
the infusion?
A. Hypertension
B. Hyperkalemia
,C. Nausea and vomiting
D. Cardiac dysrhythmias
ANS: D. Cardiac dysrhythmias (contraindictated with ventricular
tachycardia, and fibrillation) used for treatment of atrial fibrillation.
Available in Oral and injection form.
6. A patient with atrial fibrillation was started on digoxin, and 1 week
later a digoxin level was drawn. Which result is within normal
therapeutic levels for digoxin?
A. 0.4 ng/mL
B. 0.7 ng/mL
C. 2.1 ng/mL
D. 2.6 ng/mL or higher
ANS: B. 0.7 ng/mL (normal 0.5 to 2.0 ng/mL
7. When reviewing the list of medications taken by a patient who will
be receiving a new prescription for digoxin, the nurse would be
concerned about which medication that may interact with the
digoxin?
A. aspirin
B. acetaminophen (Tylenol)
C. furosemide (Lasix)
D. vitamin K
ANS: C. furosemide (Lasix); (loop Diuretics); numerous ones on page
341
8. The nurse is reviewing discharge teaching for a patient who will
be taking digoxin (Lanoxin) therapy. The patient should be taught to
avoid which foods when taking the digoxin?
A. Leafy green vegetables
B. Dairy products
C. Grapefruit juice
D. Bran muffins
ANS: D. Bran muffins
, 9. In assessing a patient before administration of a cardiac
glycoside, the nurse knows that which lab result can increase the
toxicity of the drug?
A. Potassium level 2.8 mEq/L
B. Potassium level 4.9 mEq/L
C. Sodium level 140 mEq/L
D. Calcium level 10 mg/dL
ANS: A. Potassium level 2.8 mEq/L (low potassium normal is 3.5 to
5.0)
10. The nurse administering the phosphodiesterase inhibitor
inamrinone recognizes that this drug should have a positive
inotropic effect. This effect will result in increased
A. heart rate.
B. blood vessel dilation.
C. force of cardiac contraction.
D. conduction of electrical impulses across the heart.
ANS: C. force of cardiac contraction. (increase cAMP) positive
inotropic (by more calcium available in SR)effect and vasodilation,
(inodilators)---positive chornotropic effect); USED IN ICU; ADVERSE
EFFECT...thrombocytopenia, dysrhythmia, ventricular, hypotension
and angina, hypokalemia, tremor.
11. The nurse notes in a patient's medical record that nesiritide has
been ordered. Based on this order, the nurse interprets that the
patient has which disorder?
A. Atrial fibrillation
B. Acutely decompensated heart failure with dyspnea at rest
C. Systolic heart failure
D. Long-term treatment of heart failure.
ANS: B. Acutely decompensated heart failure with dyspnea at rest
SELECT ALL THAT APPLY:
1. When a patient is experiencing digoxin toxicity, which clinical