A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Flumazenil

Acetylcysteine

Naloxone

Fab antibody fragments

Answer and Explanation

The Correct Answer is D

A) Flumazenil: Flumazenil is an antidote used to reverse the effects of benzodiazepines, which are central nervous system depressants. It is not effective in treating digoxin toxicity, as it does not interact with the cardiac glycoside effects of digoxin.

B) Acetylcysteine: Acetylcysteine is primarily used as an antidote for acetaminophen overdose and to help manage mucus in respiratory conditions. It has no effect on digoxin toxicity and would not be appropriate for treating this condition.

C) Naloxone: Naloxone is an opioid antagonist used to reverse the effects of opioid overdose. Like flumazenil and acetylcysteine, naloxone is not effective in addressing digoxin toxicity and does not counteract the effects of cardiac glycosides.

D) Fab antibody fragments: Fab antibody fragments, also known as Digoxin-specific antibody fragments (Digibind or DigiFab), are the appropriate treatment for severe digoxin toxicity. These fragments bind to digoxin, neutralizing its effects and allowing the body to eliminate it safely. This is the most effective and specific treatment for life-threatening digoxin toxicity.

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Correct Answer is ["A","C","E"]

Explanation

A) Bounding pulse:
A bounding pulse is a common sign of fluid volume excess. It indicates increased blood volume and pressure in the circulatory system, often associated with conditions such as heart failure or renal issues.

B) Urine-specific gravity greater than 1.030:
A urine-specific gravity greater than 1.030 typically indicates dehydration or concentrated urine rather than fluid volume excess. In cases of fluid volume excess, the urine-specific gravity is usually lower due to diluted urine.

C) Pitting edema:
Pitting edema, where pressure applied to the skin leaves a temporary indentation, is a clear sign of fluid volume excess. It indicates that excess fluid has accumulated in the tissues, commonly observed in conditions like heart failure or kidney dysfunction.

D) Swelling at the IV site:
Swelling at the IV site can indicate localized issues such as infiltration or phlebitis rather than generalized fluid volume excess. It is not typically a direct indicator of fluid overload.

E) Crackles upon auscultation:
Crackles (rales) heard upon auscultation of the lungs are a sign of fluid in the alveoli, which can be associated with fluid volume excess. This finding suggests that excess fluid is impacting pulmonary function, often seen in heart failure or severe fluid overload.

A. Discontinue medication if nausea occurs. B. Avoid driving until effects are known. C. Monitor for increased muscle spasms. D. Expect urine to turn orange.

Correct Answer is B

Explanation

A) Discontinue medication if nausea occurs:
While nausea can be a side effect of cyclobenzaprine, it is not typically a reason to discontinue the medication immediately. The client should contact their healthcare provider if they experience nausea or other side effects, but discontinuation should be based on medical advice.

B) Avoid driving until effects are known:
Cyclobenzaprine is a muscle relaxant that can cause drowsiness, dizziness, or impaired cognitive function. It is important for clients to avoid driving or operating heavy machinery until they are aware of how the medication affects them and if they can do so safely.

C) Monitor for increased muscle spasms:
Cyclobenzaprine is prescribed to reduce muscle spasms, so an increase in muscle spasms would be contrary to the intended effect of the medication. Clients should monitor for effectiveness and report any increase in symptoms to their healthcare provider.

D) Expect urine to turn orange:
Cyclobenzaprine does not typically cause urine to change color. Urine discoloration is not a common side effect of this medication. Clients should be informed about possible side effects, but urine discoloration is not associated with cyclobenzaprine.

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A nurse is caring for a client who is taking digoxin for heart failure and develops indications of severe digoxin toxicity. Which of the following medications should the nurse prepare to administer?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is ["A","C","E"]

Explanation

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Correct Answer is B

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