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Pharmacology Ch. 37: Cardiac Glycosides, Antianginals, Antidysrhythmics

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Pharmacology Ch. 37: Cardiac Glycosides, Antianginals, Antidysrhythmics

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Pharmacology Ch. 37: Cardiac Glycosides,
Antianginals, Antidysrhythmics

A nurse is administering digoxin, 0.125 mg, to a patient. Which nursing interventions will the
nurse implement? (Select all that apply.)

A.Checking the apical pulse rate before administration
B.Monitoring the patient's serum digoxin level
C.Instructing patient to report pulse rate less than 60
D.Advising patient to avoid foods high in potassium
E.Always giving an antacid with digoxin to reduce GI distress
- Answer A.Checking the apical pulse rate before administration
B.Monitoring the patient's serum digoxin level
C.Instructing patient to report pulse rate less than 60

*The apical pulse should be taken before digoxin administration and the drug withheld if the
heart rate is less than 60. The patient's serum digoxin level should be monitored and withheld if
in toxic range. Therapeutic level is 0.5 to 2 ng/mL. Patient should be advised to eat foods high in
potassium. Patient should be advised to avoid taking antacids with digoxin because they decrease
absorption.

When administering antianginal drugs, the nurses identifies which as the most common
response?

A.Tachycardia
B.Bradypnea
C.Hypotension
D.Dry mouth - Answer C. Hypotension

*The most common side effect of antianginal drugs is hypotension.

The nurse identifies which drug as a calcium channel blocker used for the treatment of
dysrhythmias?

A.Diltiazem (Cardizem)
B.Esmolol (Brevibloc)
C.Flecainide (Tambocor)
D.Sotalol HCl (Betapace) - Answer A. Cardizem

*Diltiazem (Cardizem) is a calcium channel blocker used to treat dysrhythmias. Esmolol
(Brevibloc) is a beta blocker. Flecainide (Tambocor) is a sodium channel blocker. Sotalol HCl
(Betapace) is a beta blocker.

, A patient with angina and a long history of severe chronic obstructive pulmonary disease is
ordered beta blocker therapy. Which beta blocker would be most effective for this patient?

A.Propranolol (Inderal)
B.Nadolol (Corgard)
C.Pindolol (Visken)
D.Atenolol (Tenormin) - Answer D. Atenolol (Tenormin)

*Cardioselective beta blockers act more strongly on the beta1 receptor, which decreases the heart
rate but avoids bronchoconstriction. Examples of selective beta blockers are atenolol (Tenormin)
and metoprolol (Lopressor, Toprol-XL). Examples of nonselective beta blockers are propranolol
(Inderal), nadolol (Corgard), and pindolol (Visken). These drugs decrease the heart rate and can
cause bronchoconstriction.

NCLEX study questions - Answer ...

The patient is receiving digoxin for treatment of heart failure. Which finding would suggest to
the nurse that heart failure is improving?

A.Pale and cool extremities
B.Absence of peripheral edema
C.Urine output of 60 mL/4h
D. Complaints of increasing dyspnea - Answer B. Absence of peripheral edema

The patient's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum
digoxin level?

A.It is in the high (elevated) range
B.It is in the low (decreased) range
C.It is within the normal range
D.It is in the low average range - Answer A. It is in the high (elevated) range

The nurse is assessing a pt for possible evidence of digitalis toxicity. The nurse acknowledges
that which is included in the signs and symptoms for digitalis toxicity?

A.Apical pulse rate of 100 bpm
B.Apical pulse rate of 72 bpm with irregular rate
C.Apical pulse of 90 bpm and an irregular rate
D.Apical pulse of 48 bpm and irregular rate - Answer D. Apical pulse of 48 bpm and irregular
rate

A patient is taking a potassium-depleting diuretic and digoxin. The nurse expects that a low
potassium level (hypokalemia) could have what effect on digoxin (Lanoxin)?

A.Increase serum digoxin sensitivity level

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