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 ["A","C","D","E"]
Explanation
Choice A reason: Use of accessory breathing muscles is a sign of respiratory distress and increased work of breathing. Accessory muscles are the muscles of the neck, chest, and abdomen that assist the diaphragm and intercostal muscles in breathing. They are normally not used for breathing, but they are recruited when the airway is obstructed or the lung function is impaired.
Choice B reason: Foul-smelling sputum is not a sign of an acute asthma episode. It is a sign of a bacterial infection or a lung abscess. Sputum is the mucus that is coughed up from the lungs. It can have different colors, textures, and odors depending on the cause and severity of the condition.
Choice C reason: Feeling of chest tightness is a sign of an acute asthma episode. It is caused by the bronchoconstriction, or the narrowing of the airways, that occurs during an asthma attack. It can also be accompanied by pain or pressure in the chest.
Choice D reason: Coughing is a sign of an acute asthma episode. It is a reflex action that tries to clear the airways of mucus, irritants, or foreign particles. It can also be triggered by the inflammation and hypersensitivity of the airways that occur during an asthma attack.
Choice E reason: Expiratory wheezing is a sign of an acute asthma episode. It is a high-pitched whistling sound that is heard when the person exhales. It is caused by the turbulent flow of air through the narrowed airways. It can also be heard on inspiration, but it is more prominent on expiration.
Correct Answer is D
Explanation
Choice A reason: This is not the cause of pulmonary symptoms in left heart failure. Decreased cardiac output is a consequence of left heart failure, which affects the perfusion of vital organs and tissues.
Choice B reason: This is not the cause of pulmonary symptoms in left heart failure. Bronchoconstriction is a feature of asthma and chronic obstructive pulmonary disease (COPD), which affect the airways and cause wheezes and shortness of breath.
Choice C reason: This is not the cause of pulmonary symptoms in left heart failure. Inflammatory pulmonary edema is a type of non-cardiogenic pulmonary edema, which occurs when the alveolar-capillary membrane is damaged by an inflammatory process, such as pneumonia or sepsis.
Choice D reason: This is the correct cause of pulmonary symptoms in left heart failure. Pulmonary vascular congestion is a result of increased pressure in the pulmonary circulation, which occurs when the left ventricle fails to pump blood effectively to the aorta and the rest of the body. This causes fluid to leak into the alveoli and interstitial spaces, leading to cough, dyspnea, crackles, and pink frothy sputum.
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