Cardiac Questions

Imagine you are a nurse overseeing the care of Mr. Thompson, who has recently been prescribed Digoxin for his chronic heart failure. As his nurse, what are some key considerations you need to monitor for Mr. Thompson? Select all that apply.

• Monitor peaks & troughs

• Educate Mr. Thompson that the therapeutic levels are between 1.5-2.0

• Mr. Thompson's potassium level can be at < 3.0 when administering the drug

• Watch for headache, halos, nausea, delirium, bradycardia

Answer explanation

Therapeutic levels 0.8-1.2

K needs to be ABOVE 3.0 to prevent drug toxicity. Already has a high risk for hypokalemia with this drug.

A patient is prescribed HCTZ and also has an order

for Digoxin? What should the nurse do next?

• Give the two medications

• Measure the serum potassium

• Call the provider to question the order

• Don't give either medication

Answer explanation

Both drugs have SE of hypokalemia, call provider to question the order, may need to change to a potassium sparing diuretic (spironolactone)

John, who has been prescribed furosemide, is about to receive some advice from his nurse. What key points should be included in this advice? Select all that apply

• This type of diuretic is the most potent.

• It is a potassium sparing diuretic so we do not need to monitor your

  levels.

• We will need to complete daily weights on you to make sure the

  medication is working.

• You are not at risk for hypotension.

• I encourage you to move slowly as you will have decreased BP due to the

  medication.

Answer explanation

Diuretics all have the potential SE of hypotension! Fluid is leaving the body. K needs to be monitored for all but spironolactone (sparing).

Imagine you are a nurse caring for John, who has recently been prescribed Spironolactone for his heart condition. What interventions should you consider? Select all that apply.

• Monitor I&Os

• Teach John that he can eat salt substitutes

• Watch for hyperkalemia

• Administer the medication at night

• This medication can also cause dysrhythmias and hyponatremia

Answer explanation

No salt subs - they contain K this is a potassium sparing diuretic

Give diuretics in the morning because pt may fall trying to get up in the middle of the night to use the bathroom.

Which of these patients might need an osmotic

diuretic? Select all that apply.

• patient with chronic heart failure

• patient with an increased intracranial pressure of 20

• patient who is having chest pain

• patient who is complaining of severe eye pain and pressure and has a

  past medical history of primary angle glaucoma

Answer explanation

Mannitol = fast acting potent diuretic for emergencies.

Imagine you're a nurse and a patient arrives in distress, exhibiting severe chest pain and difficulty breathing. After assessment, the patient is administered Nitroglycerin. As their nurse, what are the key observations and precautions you should be mindful of?

Select all that apply.

• Watch for an increase in blood pressure

• Put fall risk precautions in place

• If they complain of a headache this is an adverse effect

• If given sublingually teach the patient not to chew the medication

Answer explanation

Risk for hypotension with this drug = fall risk

This drug vasodilates => HA VERY common SE not AE, treat with tylenol.

A COPD patient is prescribed a beta blocker to manage his hypertension. What are should the nurse NOT focus on with this patient?

• Make sure the medication is cardioselective.

• Watch for a decrease HR and BP.

• If <60 HR do not give medication.

• Only check the BP and HR after giving to see if it worked.

Answer explanation

risk of bradycardia - dont want to give HR under 60 (dr usually adds in notes to hold under xyz HR)

Dont give a drug without first checking if vitals are appropriate.

A patient is on Diltiazem for his Atrial Fibrillation.

Which is he most at risk for?

• Pain in his left arm

• High sodium levels

• More dysrhythmias

• Kidney failure

Answer explanation

slows conduction and HR, must monitor!

After being prescribed captopril for her hypertension, Emily notices some unexpected changes. Which of the following symptoms should she report to her doctor? Select all that apply.

• Hypokalemia

• Angioedema

• Dry Cough

• HTN

• Headache

Answer explanation

HYPERkalemia

HYPOtension

A 65-year-old man with a history of heart disease is brought to the emergency room. His heart rate is measured at 35 beats per minute, and he appears increasingly confused and lethargic. Which medication should be administered?

• Verapamil

• Amiodarone

• Atropine

• Atorvastatin

Answer explanation

atropine is treatment for bradycardia