DIF: Cognitive Level: Understanding (Comprehension) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 8. The other foods do not affect digoxin levels. Bran muffins ANS: D Bran, in large amounts, may decrease the absorption of oral digitalis drugs. The nurse will teach the patient to avoid which foods when taking the digoxin? a. The nurse is reviewing discharge teaching for a patient who will be taking digoxin (Lanoxin) therapy. DIF: Cognitive Level: Analyzing (Analysis) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 7. ANS: B The normal therapeutic drug level of digoxin is between 0 and 2 ng/mL. Which interpretation by the nurse is correct? a. A patient has a digoxin level of 1 ng/mL. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential Copyright © 2020, Elsevier Inc. It may also cause hypotension, hypokalemia, and other effects, but not nausea and vomiting. Cardiac dysrhythmias ANS: D The primary adverse effects seen with milrinone are cardiac dysrhythmias, mainly ventricular. What adverse effect of this drug will the nurse watch for when assessing this patient during the infusion? a. A patient has been placed on a milrinone (Primacor) infusion as part of the therapy for end-stage heart failure. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 5. ANS: D Digoxin immune Fab (Digifab) is the antidote for a severe digoxin overdose and is given to reverse the life-threatening cardiotoxic effects. “This drug is an antidote to digoxin and will help your heart to return to normal functioning. “It causes your heart to beat at a slower rate.” d. “This drug helps to lower your potassium levels.” c. The patient asks the nurse why the medication is ordered. The patient has been admitted to the telemetry unit, where the physician has ordered digoxin immune Fab (Digifab). A patient has been taking digoxin at home but took an accidental overdose and has developed toxicity. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Evaluation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 4. Decreased ectopic beats ANS: B A negative chronotropic effect results in a decreased heart rate this is one effect of cardiac glycosides. How would this drug effect be evident in the patient? a. While assessing a patient who is receiving intravenous digitalis, the nurse recognizes that the drug has a negative chronotropic effect. DIF: Cognitive Level: Analyzing (Analysis) TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity: Reduction of Risk Potential 3. Administering the drug or withholding the diuretic are incorrect options. If a patient indicates these visual problems, the nurse needs to assess for other signs and symptoms of digoxin toxicity including bradycardia, headache, dizziness, confusion, nausea, and blurred vision, and then notify the prescriber. ANS: A Seeing colors around lights is one potential indication of developing digoxin toxicity. Document this finding, and reassess in 1 hour. Administer the digoxin and diuretic together as ordered. Assess the patient for symptoms of digoxin toxicity. When the nurse enters the room with the morning medications, the patient states, “I am seeing a funny yellow color around the lights.” What is the nurse’s next action? a. A patient is taking digoxin (Lanoxin) and a loop diuretic daily. DIF: Cognitive Level: Applying (Application) TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies 2. ANS: D Digoxin doses are held and the prescriber notified if the apical pulse is 60 beats/min or lower or is higher than 100 beats/min. Withhold the dose, and notify the prescriber. Check the radial pulse for 1 full minute. Administer the dose, and notify the prescriber. A patient about to receive a morning dose of digoxin has an apical pulse of 50 beats/min. 1 Chapter 24: Heart Failure Drugs Lilley: Pharmacology and the Nursing Process, 9th Edition MULTIPLE CHOICE 1.
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