Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?
Report nausea and vomiting to your health care provider.
Auditory hallucinations are common adverse effects.
Decrease the amount of high-potassium foods you eat.
Omit your dose of digoxin if your pulse is 70.
The Correct Answer is A
Choice A reason: This is the correct instruction by the nurse. Nausea and vomiting are signs of digoxin toxicity, which can be life-threatening. The patient should report these symptoms to their health care provider as soon as possible and have their digoxin level checked.
Choice B reason: This is not a correct instruction by the nurse. Auditory hallucinations are not common adverse effects of digoxin. They are more likely to occur with other drugs, such as antipsychotics or opioids.
Choice C reason: This is not a correct instruction by the nurse. Decreasing the amount of high-potassium foods can increase the risk of digoxin toxicity, as potassium competes with digoxin for binding sites on the cardiac cells. The patient should maintain a normal potassium intake and avoid sudden changes in their diet.
Choice D reason: This is not a correct instruction by the nurse. Omitting the dose of digoxin if the pulse is 70 can lead to underdosing and ineffective treatment of heart failure. The patient should only omit the dose of digoxin if their pulse is below 60, as this indicates bradycardia, which is another sign of digoxin toxicity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This is not the best response by the nurse. Stopping the medication abruptly can cause rebound hypertension and other complications. The patient should not stop taking the medication without consulting their health care provider.
Choice B reason: This is not the best response by the nurse. Cutting the pill in half and taking a reduced dosage can affect the efficacy and safety of the medication. The patient should not change the dosage of the medication without consulting their health care provider.
Choice C reason: This is the best response by the nurse. Dizziness is a common side effect of ACE inhibitors, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this side effect is usually mild and transient, and can be prevented by rising slowly from a sitting or lying position, drinking plenty of fluids, and avoiding alcohol.
Choice D reason: This is not the best response by the nurse. Scheduling the patient to visit the health care provider today is not necessary, unless the dizziness is severe, persistent, or accompanied by other symptoms, such as chest pain, fainting, or palpitations. The patient should be advised to monitor their blood pressure and report any significant changes or concerns to their health care provider.
Correct Answer is B
Explanation
Choice A reason: This is not the preferred agent for the initial treatment of heart failure. Vasodilators are a class of medications that lower the blood pressure by relaxing the blood vessels and reducing the resistance to blood flow. They can be used to treat hypertension, angina, and heart failure, but they are usually added to other medications, such as diuretics or beta blockers, to improve the symptoms and outcomes.
Choice B reason: This is the preferred agent for the initial treatment of heart failure. Diuretics are a class of medications that increase the urine output and reduce the fluid retention in the body. They can be used to treat hypertension, edema, and heart failure, as they reduce the preload and afterload on the heart, and decrease the pulmonary congestion and peripheral edema.
Choice C reason: This is not the preferred agent for the initial treatment of heart failure. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias, but they are not recommended for most patients with heart failure, as they may worsen the cardiac function and increase the mortality.
Choice D reason: This is not the preferred agent for the initial treatment of heart failure. Direct renin inhibitors are a class of medications that lower the blood pressure by inhibiting the enzyme renin, which initiates the renin-angiotensin-aldosterone system, a hormonal pathway that regulates the blood pressure and fluid balance. They can be used to treat hypertension, but they have not been proven to be effective or safe for patients with heart failure.
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