PN VATI Pharmacology
A client with a digoxin level of 2.4 ng/ml has a heart rate of 39. The health care provider prescribes atropine sulfate. Which of the following best describes the intended action of atropine for this client?
a. To reduce peristalsis and urinary bladder tone.
b. To stimulate the SA node and sympathetic fibers to increase the rate
c. To accelerate the heart rate by interfering with vagal impulses
d. To dry oral and tracheobronchial secretions. - answersc. To accelerate the heart rate by interfering with vagal impulses. Atropine accelerates the heart rate by interfering with vagal impulses. It is given IVP at doses of 0.5mg to 1.0mg per dose; every 3 to 5 minutes; up to 2.0mg. Doses less than 0.5mg may cause a paradoxical slowing of the heart rate. When Atropine is given to a client with history of an MI it should be used with great caution; increasing the heart rate
also increases myocardial oxygen consumption!
A client is prescribed digoxin 1mg by mouth QID. The client states that the objects in his
room have a yellowish tinge and he is nauseated. Select the most appropriate nursing action at this time.
a. Administer the medication and observe the client for further nausea.
b. Hold the drug and call the health care provider.
c. Count the apical pulse; if it is regular and above 60, administer the drug as ordered.
d. Hold the medication and count the apical pulse before the next dose is to be given. - answersb. Hold the drug and call the health care provider. This client is showing signs of digitalis toxicity. The most appropriate action is to hold the drug and call the health care provider. Severe arrhythmia may develop if action is not taken.
A client diagnosed with preterm labor has been prescribed nifedipine. The client asks the nurse why this particular medication has been prescribed. Which of the following statements by the nurse is correct? a. To lower your blood pressure
b. To promote development of your baby's lungs
c. To decrease the intensity of your pain
d. To relax your muscles of your uterus - answersd. To relax your muscles of your uterus The use of nifedipine for the treatment of preterm labor is an unlabeled use of the drug. Nifedipine, a calcium channel blocker, is more commonly used to treat high blood pressure and heart disease. Smooth muscle tissue, like the uterus, needs calcium to contract. Nifedipine blocks the passage of calcium into certain tissues, relaxing the uterine muscles and smooth muscles of blood vessels throughout the body.
A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). An intravenous infusion of regular insulin has been started. Which of the following nursing interventions is most appropriate for this client?
a. Obtain an arterial blood gas every 2 hours
b. Monitor blood glucose levels every 4 hours
c. Ensure glucagon is readily available d. Add the prescribed dose of NPH insulin to the IV infusion - answersc. Ensure glucagon is readily available Glucagon and D50 are used for rapid treatment of hypoglycemia which can occur when insulin is administered intravenously
A nurse is evaluating a client's understanding of lithium. Which statement by the client indicates a need for further education?
a. "I will drink 8-12 glasses of water a day."
b. "I should take the medication on an empty stomach." c. "I should have my blood level drawn as directed."
d. "I will contact my provider if I develop diarrhea." - answersb. "I should take the medication on an empty stomach." Lithium should be taken with meals or milk to decrease gastric upset.
A nurse is caring for a client taking captopril. Which finding would require immediate attention for this client?
a. Sodium 133
b. Potassium 5.8 c. Blood pressure 96/48
d. Pulse 56 - answersb. potassium of 5.8 is elevated- normal is 3.5-5. One effect of captopril is elevation of potassium levels because this drug inhibits the formation of angiotensin II and blocks the release of aldosterone. The blocking of the aldosterone results in sodium excretion and potassium retention. Hyperkalemia can result in cardiac arrhythmias and if untreated lead to cardiac arrest.
A client with a digoxin level of 2.4 ng/ml has a heart rate of 39. The health care provider prescribes atropine sulfate. Which of the following best describes the intended action of atropine for this client?
a. To reduce peristalsis and urinary bladder tone.
b. To stimulate the SA node and sympathetic fibers to increase the rate
c. To accelerate the heart rate by interfering with vagal impulses
d. To dry oral and tracheobronchial secretions. - answersc. To accelerate the heart rate by interfering with vagal impulses. Atropine accelerates the heart rate by interfering with vagal impulses. It is given IVP at doses of 0.5mg to 1.0mg per dose; every 3 to 5 minutes; up to 2.0mg. Doses less than 0.5mg may cause a paradoxical slowing of the heart rate. When Atropine is given to a client with history of an MI it should be used with great caution; increasing the heart rate
also increases myocardial oxygen consumption!
A client is prescribed digoxin 1mg by mouth QID. The client states that the objects in his
room have a yellowish tinge and he is nauseated. Select the most appropriate nursing action at this time.
a. Administer the medication and observe the client for further nausea.
b. Hold the drug and call the health care provider.
c. Count the apical pulse; if it is regular and above 60, administer the drug as ordered.
d. Hold the medication and count the apical pulse before the next dose is to be given. - answersb. Hold the drug and call the health care provider. This client is showing signs of digitalis toxicity. The most appropriate action is to hold the drug and call the health care provider. Severe arrhythmia may develop if action is not taken.
A client diagnosed with preterm labor has been prescribed nifedipine. The client asks the nurse why this particular medication has been prescribed. Which of the following statements by the nurse is correct? a. To lower your blood pressure
b. To promote development of your baby's lungs
c. To decrease the intensity of your pain
d. To relax your muscles of your uterus - answersd. To relax your muscles of your uterus The use of nifedipine for the treatment of preterm labor is an unlabeled use of the drug. Nifedipine, a calcium channel blocker, is more commonly used to treat high blood pressure and heart disease. Smooth muscle tissue, like the uterus, needs calcium to contract. Nifedipine blocks the passage of calcium into certain tissues, relaxing the uterine muscles and smooth muscles of blood vessels throughout the body.
A client is admitted to the hospital with a diagnosis of diabetic ketoacidosis (DKA). An intravenous infusion of regular insulin has been started. Which of the following nursing interventions is most appropriate for this client?
a. Obtain an arterial blood gas every 2 hours
b. Monitor blood glucose levels every 4 hours
c. Ensure glucagon is readily available d. Add the prescribed dose of NPH insulin to the IV infusion - answersc. Ensure glucagon is readily available Glucagon and D50 are used for rapid treatment of hypoglycemia which can occur when insulin is administered intravenously
A nurse is evaluating a client's understanding of lithium. Which statement by the client indicates a need for further education?
a. "I will drink 8-12 glasses of water a day."
b. "I should take the medication on an empty stomach." c. "I should have my blood level drawn as directed."
d. "I will contact my provider if I develop diarrhea." - answersb. "I should take the medication on an empty stomach." Lithium should be taken with meals or milk to decrease gastric upset.
A nurse is caring for a client taking captopril. Which finding would require immediate attention for this client?
a. Sodium 133
b. Potassium 5.8 c. Blood pressure 96/48
d. Pulse 56 - answersb. potassium of 5.8 is elevated- normal is 3.5-5. One effect of captopril is elevation of potassium levels because this drug inhibits the formation of angiotensin II and blocks the release of aldosterone. The blocking of the aldosterone results in sodium excretion and potassium retention. Hyperkalemia can result in cardiac arrhythmias and if untreated lead to cardiac arrest.
