A patient is being treated for heart failure. Labs: Sodium 146 meq/L, Potassium 4.2 mmol/L, Hemoglobin 10.5 gm/dL, White Blood Cells 12.2, digoxin level 0.8 ng/mL
VS: BP 118/66, apical heart rate 68, O2 96% on 2L nasal cannula, temperature 98.4°F
What will the nurse do with the digoxin order?
Recheck heart rate in one hour
Give the digoxin as ordered
Call prescriber and ask for chest x-ray
Hold the digoxin and call the MD
The Correct Answer is B
Choice A reason: This choice is incorrect because there is no need to recheck the heart rate in one hour before giving the digoxin. The client's apical heart rate is within the normal range (60 to 100 beats per minute) and does not indicate bradycardia (slow heart rate), which is a sign of digoxin toxicity. The nurse should check the apical heart rate for one full minute before giving the digoxin and withhold the dose if the heart rate is below 60 beats per minute.
Choice B reason: This choice is correct because the client's digoxin level is within the therapeutic range (0.5 to 2.0 ng/mL) and does not indicate digoxin toxicity or underdosing. The client's vital signs and labs are also stable and do not indicate any adverse effects of digoxin. Digoxin is a cardiac glycoside that improves the contractility and efficiency of the heart and helps to control the heart rate and rhythm in clients with heart failure. The nurse should give the digoxin as ordered and monitor the client's response and digoxin level.
Choice C reason: This choice is incorrect because there is no indication for a chest x-ray for this client. A chest x-ray is a diagnostic test that can show the size and shape of the heart and lungs and detect any abnormalities, such as fluid accumulation, infection, or tumors. The client's symptoms and labs do not suggest any pulmonary complications or worsening of heart failure that would require a chest x-ray. The nurse should follow the provider's orders and protocols for chest x-ray indications.
Choice D reason: This choice is incorrect because there is no reason to hold the digoxin and call the MD for this client. The client's digoxin level is not too high or too low and does not require dose adjustment or discontinuation. The client's vital signs and labs are also normal and do not indicate any signs of digoxin toxicity or adverse effects. Holding the digoxin could cause the client's heart failure to worsen or cause arrhythmias. The nurse should only hold the digoxin and call the MD if the client has signs of digoxin toxicity, such as nausea, vomiting, visual disturbances, confusion, or bradycardia. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Maintaining a healthy weight is important for lowering cholesterol levels and reducing the risk of cardiovascular disease. Obesity is associated with higher levels of LDL-cholesterol (the "bad" cholesterol) and lower levels of HDL-cholesterol (the "good" cholesterol). Losing weight can improve these ratios and lower blood pressure. ¹
Choice B reason: Avoiding cigarettes and other nicotine products is essential for preventing cardiovascular disease. Smoking damages the blood vessels and increases the risk of atherosclerosis, which is the buildup of plaque in the arteries. Smoking also lowers HDL-cholesterol and raises triglycerides, another type of fat in the blood. Quitting smoking can improve cholesterol levels and lower the risk of heart attack and stroke. ²
Choice C reason: Importance of regular exercise is another key factor for improving cholesterol levels and cardiovascular health. Exercise helps to lower LDL-cholesterol and raise HDL-cholesterol, as well as lower blood pressure and blood sugar. Exercise also strengthens the heart muscle and improves blood flow. The American Heart Association recommends at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, or a combination of both. ³
Choice D reason: Positive stress management techniques are not directly related to cholesterol levels or statin medications, but they may have some benefits for cardiovascular health. Stress can increase blood pressure and heart rate, and may trigger unhealthy behaviors such as smoking, drinking, or overeating. Stress can also affect the immune system and inflammation, which may contribute to atherosclerosis. Learning to cope with stress in healthy ways, such as meditation, yoga, breathing exercises, or counseling, may help to lower the risk of cardiovascular disease. ⁴
Choice E reason: Healthy low fat diet options are an important part of lowering cholesterol levels and preventing cardiovascular disease. A diet that is high in saturated fat, trans fat, and cholesterol can raise LDL-cholesterol and lower HDL-cholesterol. A diet that is low in fat and high in fiber, fruits, vegetables, whole grains, and lean protein can lower LDL-cholesterol and raise HDL-cholesterol. Some foods, such as oats, nuts, soy, and fish, may have additional benefits for cholesterol levels. .
Correct Answer is ["4"]
Explanation
To determine how many capsules of rifampin the nurse should administer per dose, we can follow these steps:
Convert the client's weight from pounds to kilograms:
132 lb ÷ 2.2 = 59.9 kg (rounded to one decimal place)
Calculate the total daily dose of rifampin:
20 mg/kg/day × 59.9 kg = 1198 mg/day
Divide the total daily dose into two equal doses for administration:
1198 mg/day ÷ 2 = 599 mg per dose
Calculate the number of capsules needed per dose:
150 mg per capsule
599 mg per dose ÷ 150 mg per capsule = 3.9933...
Rounding to the nearest whole number, the nurse should administer 4 capsules per dose.
Therefore, the nurse should administer 4 capsules of rifampin per dose.
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