Pharmacology (NSG 124)

The nurse is preparing to administer the cardiac glycoside digoxin to a patient. The nurse knows which of the following are correct? Select all that apply. If heart rate is less than 90 beats/min or if a change in rhythm is detected, withhold digoxin and notify the prescriber. Visual disturbances (blurred or yellow vision) frequently indicate a therapeutic effect and provider should be notified. Teach patients to recognize early signs of hypokalemia (e.g., muscle weakness), and instruct them to notify the prescriber if these develop. Inform outpatients about the danger of dysrhythmias. Teach them to monitor their pulses for rate and rhythm, and instruct them to notify the prescriber if significant changes occur.

What does the nurse need to understand when preparing to administer the cardiac glycoside digoxin? Select all that apply. Drug increases cardiac output which decreases urine production More effective when combined with potassium wasting diuretics. Drug decreases peripheral and pulmonary edema Improves cardiac output Drug has a narrow therapeutic range

Dysrhythmias are the most serious effects of digoxin.

The nurse knows which of the following are correct physiologic adaptation to reduced cardiac output? Select all that apply. Decreased venous tone – depletion of venous tone decreases venous pressure and thereby increases ventricular filling. Because of Starling's mechanism, decreased filling decreases stroke volume. Decreased heart rate - deceleration of heart rate increases cardiac output, thereby helping improve tissue perfusion. Water retention and increased blood volume - reduced cardiac output causes a reduction in renal blood flow, which in turn decreases glomerular filtration rate (GFR). As a result, urine production is decreased and water is retained. Retention of water increases blood volume. Increased sympathetic tone - Heart failure causes arterial pressure to fall. In response, the baroreceptor reflex increases sympathetic output to the heart, veins, and arterioles. At the same time, parasympathetic effects on the heart are reduced. Natriuretic peptides - In response to stretching of the atria and dilation of the ventricles, the heart releases two natriuretic peptides: atrial natriuretic peptide (ANP) and B-natriuretic peptide (BNP).

The nurse is preparing to administer an antihypertensive drug to a patient. The nurse knows which of the following are correct? Select all that apply. Avoid drugs that can exacerbate comorbid conditions. For example, don't give beta blockers to patients who have bradycardia, AV block, or asthma. Teach patients to self-monitor their BP and to maintain a BP record. Antihypertensive regimens frequently contain two or more drugs, decreasing the risk of adverse interactions. Encourage patients to consume no more than 5000 mg of salt daily and provide them with information on the salt content of foods. Educate patients about the long-term consequences of hypertension and the ability of lifestyle changes and drug therapy to decrease morbidity and prolong life. Inform patients that drugs do not cure hypertension; therefore, the medication prescribed must usually be taken lifelong. Encourage patients to limit alcohol consumption to 2 ounce/day (for most men) and 1 ounce/day (for women and lighter weight men).

The nurse is preparing to administer an antihypertensive drug to a patient. The nurse knows which of the following are correct? Select all that apply. Encourage patients to limit alcohol consumption to 2 ounce/day (for most men) and 1 ounce/day (for women and lighter weight men). Educate patients about the long-term consequences of hypertension and the ability of lifestyle changes and drug therapy to decrease morbidity and prolong life. Inform patients that drugs do not cure hypertension; therefore, the medication prescribed must usually be taken lifelong. Encourage patients to consume no more than 5000 mg of salt daily and provide them with information on the salt content of foods. Teach patient goal is to reduce blood pressure to less than 130/80 mm Hg. Teach patients to self-monitor their BP and to maintain a BP record. The goal of antihypertensive therapy is to prevent the long-term sequelae of hypertension (heart disease, kidney disease, stroke).