Cardiac Medications

A client has been admitted through the emergency department and requires emergency surgery. The client has been receiving heparin. What nursing intervention is essential?

• Teach the client about the phenytoin

• Administer protamine sulfate.

• Assess the INR before surgery

• Administer vitamin K

In administering a newly initiated order for captopril, an ACE inhibitor, discharge instructions should indicate that which of the following adverse effects is most common?

• tinnitus

• muscle weakness

• dry, nonproductive persistent cough

• constipation

Which of the following is indicated for initial drug therapy in a patient newly diagnosed with uncomplicated hypertension (stage 1)?

• calcium channel blocker

   

• potassium-sparing diuretic

•  direct-acting vasodilator

• thiazide diuretic

The health care provider prescribes nitroglycerin 2% ointment, 1.5-inch dose every 4 hours. To accurately apply the ointment, the patient should be instructed to do which of the following?

• rub the ointment into the skin to enhance absorption

• leave previous ointment on for 4 hours after applying a new dose

• place the ointment on a distal part of the lower body

• rotate application sites to decrease skin irritation

A patient taking nitroglycerin for angina reports developing a headache after taking more than one tablet. The nurse should inform him of which of the following?

• Headache is a common side effect due to the vasodilating effects of the medication.

• A headache indicates that a person is allergic to the nitroglycerin.

• The experience of headache means that the levels of nitroglycerin are toxic.

• The experience of headache likely means that the tablets have passed their expiration date.

A 57-year-old man taking metoprolol presents to the cardiac clinic following a myocardial infarction. He reports that he continues to smoke. Smoking may contribute to what effect on beta-adrenergic blocking activity?

•  reduce the efficacy

•  potentiate an increase in intracranial pressure

•  precipitate ventricular fibrillation

• increase the incidence of adverse effects

  A 72-year-old woman with angina pectoris, who is being discontinued from beta-adrenergic blockers, asks the nurse, “Why can’t I just stop taking the drug today if it’s not working anyway?” The nurse instructs the patient that failure to taper the drug slowly may lead to which of the following?

• drug fever

•  significant bronchoconstriction

•  development of heart failure

•    worsening of her angina symptoms

 An elderly patient is admitted to the cardiac intensive care unit with symptoms associated with the right side of the heart. Which of the following blood values is most important to monitor based on the patient’s risk factors?

• complete blood count (CBC)

• liver enzymes

• bleeding and clotting time

• blood glucose

A patient is taking digoxin for atrial fibrillation. Which of the following assessment findings would indicate that the digoxin should be held and the health care provider should be notified?

•  respiratory rate of 20 breaths/min

• pulse rate of 80 beats/min

• respiratory rate of 12 breaths/min

•  pulse rate of 52 beats/min

The home care nurse is visiting a patient who has a history of heart failure. The patient is taking digoxin 0.125 mg orally each day. During the assessment, the patient states he has been nauseated since the home care visit 3 days ago. The nurse suspects he has developed digoxin toxicity. Which of the following factors makes this patient more prone to the development of digoxin toxicity?

• creatinine level of 2.0 mg/dL

• potassium level of 4.0 mEq/L

• calcium level of 8.5 mg/100 mL

• magnesium level of 2.0 mg/100 mL