The nurse acknowledges that beta blockers are as effective as antianginals because they do what?
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Sildenafil (Viagra) is prescribed to treat a client with erectile dysfunction. A nurse reviews the client's medical record and would question the prescription if which of the following is noted in the client's history?1. Neuralgia Show A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3.0 mEq/L and is complaining of anorexia. A health care provider prescribes a digoxin level to rule out digoxin toxicity. A nurse checks the results, knowing that which of the following is the therapeutic serum level (range) for digoxin? A nurse is monitoring a client who is taking propranolol (Inderal LA). Which data collection finding would indicate a potential serious complication associated with propranolol? 2. The development of audible expiratory wheezes Isosorbide mononitrate (Imdur) is prescribed for a client with angina pectoris. The client tells the nurse that the medication is causing a chronic
headache. The nurse appropriately suggests that the client: 3. Take the medication with food. A client is diagnosed with an acute myocardial infarction
and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 3. Monitor for signs of bleeding.
A nurse is planning to administer hydrochlorothiazide (HydroDIURIL) to a client. The nurse understands that which of the following are concerns related to the administration of this medication? 3. Hypokalemia, hyperglycemia, sulfa allergy A home health care nurse is visiting a client with elevated triglyceride levels and a serum cholesterol level of 398 mg/dL. The client is taking cholestyramine (Questran). Which of the following statements, if made by the client, indicates the need for further education? 4. "I'll continue my nicotinic acid from the health food store." A client is on nicotinic acid (niacin) for hyperlipidemia and the nurse provides
instructions to the client about the medication. Which statement by the client would indicate an understanding of the instructions? 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum therapeutic range for digoxin? a. 0.1 to 1.5 ng/mL The client's serum digoxin level is 3.0 ng/mL. What does the nurse know about this serum digoxin level? a. It is in the high (elevated) range. a. It is in the high (elevated) range. The nurse is assessing the client for possible evidence of digitalis toxicity. The nurse acknowledges that which is included in the signs and symptoms for digitalis toxicity? a. Pulse (heart) rate of 100 beats/min d. Pulse below 60 beats/min and irregular rate The client is also taking a diuretic that decreases her potassium level. The nurse expects that a low potassium level (hypokalemia) could have what effect on the digoxin? a. Increase the serum digoxin sensitivity level a. Increase the serum digoxin sensitivity level When a client first takes a nitrate, the nurse expects which symptom that often occurs? a. Nausea and vomiting The nurse acknowledges that beta blockers are as effective as antianginals because they do what? a. Increase oxygen to the systemic circulation. c. Decrease heart rate and decrease myocardial contractility. The health care provider is planning to discontinue a client's beta blocker. What instruction should the nurse give the client regarding the beta blocker? a. The beta blocker should
be abruptly stopped when another cardiac drug is prescribed. b. The beta blocker should NOT be abruptly stopped; the dose should be tapered down. A client is to be discharged home with a transdermal nitroglycerin patch. Which instruction will the nurse include in the client's teaching plan? a. "Apply the patch to a nonhairy area of the upper torso or arm." a. "Apply the patch to a nonhairy area of the upper torso or arm." A nurse is monitoring a client with angina for therapeutic effects of nitroglycerin. Which assessment finding indicates that the nitroglycerin has been effective? a. Blood pressure 120/80 mm Hg d. Client stating that pain is 0 out of 10 The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action? a. Blood pressure 110/90 mm Hg Which statement made by the client demonstrates a need for further instruction regarding the use of nitroglycerin? a. "If I get a headache, I should keep taking nitroglycerin and use Tylenol for pain relief." d. "I can take up to five tablets at 3-minute intervals for chest pain if necessary." Which client assessment would assist the nurse in evaluating therapeutic effects of a calcium channel blocker? a. Client states that she has no chest pain. a. Client states that she has no chest pain. What statement is the most important for the nurse to include in the teaching plan for a client who has started on a transdermal nitroglycerin patch? a. "This medication works faster than sublingual nitroglycerin works." d. "This medication will work for 24 hours and you will need to change the patch daily." What will the nurse instruct the client to do to prevent the development of tolerance to nitroglycerin? a. Apply the
nitroglycerin patch every other day. c. Apply the nitroglycerin patch for 14 hours and remove it for 10 hours at night. Before the nurse administers isosorbide mononitrate (Imdur), what is a priority nursing assessment? a. Assess serum electrolytes. c. Assess blood pressure. The client asks the nurse how nitroglycerin should be stored while traveling. What is the nurse's best response? a. "You can protect it from heat by placing the bottle in an ice chest." b. "It's best to keep it in its original container away from heat and light." Which statement indicates to the nurse that the client understands sublingual nitroglycerin medication instructions? a. "I
will take up to five doses every 3 minutes for chest pain." d. "I should sit or lie down after I take a nitroglycerin tablet to prevent dizziness." What instruction should the nurse provide to the client who needs to apply nitroglycerin ointment? a. Use the fingers to spread the ointment evenly over a 3-inch area. b. Apply the ointment to a nonhairy part of the upper torso. A client receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse's priority action? a.
Assess the client's lung sounds. b. Decrease the intravenous nitroglycerin by 10 mcg/min. The nurse is monitoring a client taking digoxin (Lanoxin) for treatment of heart failure. Which assessment finding indicates a therapeutic effect of the drug? a. Heart rate 110 beats per minute b. Heart rate 58 beats per minute A client's serum digoxin level is drawn, and it is 0.4 ng/mL. What is the nurse's priority action? a. Administer ordered dose of digoxin. a. Administer ordered dose of digoxin. A client is taking digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg. When the nurse enters the room, the client states, "There are yellow halos around the lights." Which action will the nurse take? a. Evaluate digoxin levels. a. Evaluate digoxin levels. Which assessment finding will alert the nurse to suspect early digitalis toxicity? a. Loss of appetite with slight bradycardia a. Loss of appetite with slight bradycardia The nurse reviews a client's laboratory values and finds a digoxin level of 10 ng/mL and a serum potassium level of 5.9 mEq/L. What is the nurse's primary intervention? a. To administer atropine b. To administer digoxin immune FAB A client is to begin treatment for short-term management of heart failure with milrinone lactate (Primacor). What is the priority nursing action? a. Administer digoxin via IV infusion with
the Primacor. c. Monitor blood pressure continuously. A client's recently drawn serum lidocaine drug level is 3.0 mcg/mL. What is the nurse's priority intervention? a. Increase the lidocaine infusion. c. Continue to monitor the client. A nurse is caring for a client who has been started on ibutilide (Corvert). Which assessment is a priority for this client? a. Blood pressure measurement Which assessment finding will alert the nurse to possible toxic effects of amiodarone? a. Heart rate 100 beats per minute A client is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. What type of electrolyte imbalance does the nurse expect to occur? a. Hypocalcemia What would cause the same client's electrolyte imbalance? a. High dose of digoxin A nurse teaching a client who has diabetes mellitus and is taking hydrochlorothiazide 50 mg/day. The teaching should include the importance of monitoring which levels? a. Hemoglobin and hematocrit A client has heart failure and is prescribed Lasix. The nurse is aware that furosemide (Lasix) is what kind of drug? a. Thiazide diuretic c. High-ceiling (loop) diuretic The nurse acknowledges that which condition could occur when taking furosemide? a. Hypokalemia For the client taking a diuretic, a combination such as triamterene and hydrochlorothiazide may be prescribed. The nurse realizes that this combination is ordered for which purpose? a. To decrease the serum potassium level b. To increase the serum potassium level The client has been receiving spironolactone (Aldactone) 50 mg/day for heart failure. The nurse should closely monitor the client for which condition? a. Hypokalemia Which laboratory value will the nurse report to the health care provider as a potential adverse response to hydrochlorothiazide (HydroDIURIL)? a. Sodium level of 140 mEq/L b. Fasting blood glucose level of 140 mg/dL What is the best information for the nurse to provide to the client who is receiving spironolactone (Aldactone) and furosemide (Lasix) therapy? a. "Moderate doses of two
different diuretics are more effective than a large dose of one." b. "This combination promotes diuresis but decreases the risk of hypokalemia." A client with acute pulmonary edema receives furosemide (Lasix). What assessment finding indicates that the intervention is working? a. Potassium level decreased from 4.5 to 3.5 mEq/L. The nurse is aware that which group(s) of antihypertensive drugs are less effective in African-American clients? a. Diuretics c. Beta blockers and ACE inhibitors The nurse knows that which diuretic is most frequently combined with an antihypertensive drug? a. chlorthalidone The nurse explains that which beta blocker category is preferred for treating hypertension? a. Beta1 blocker Captopril (Capoten) has been ordered for a client. The nurse teaches the client that ACE inhibitors have which common side effects? a. Nausea and vomiting d. Constant, irritating cough A client is prescribed losartan (Cozaar). The nurse teaches the client that an angiotensin II receptor blocker (ARB) acts by doing what? a. Inhibiting angiotensin-converting enzyme b. Blocking angiotensin II from AT1 receptors Which statement indicates that the client needs additional instruction about antihypertensive treatment? a. "I will check my blood pressure daily and take my medication when it is over 140/90." a. "I will check my blood pressure daily and take my medication when it is over 140/90." A nurse is caring for a client who is taking an angiotensin-converting enzyme inhibitor and develops a dry, nonproductive cough. What is the nurse's priority action? a. Call the health care provider to switch the medication. a. Call the health care provider to switch the medication. The nurse is reviewing a medication history on a client taking an ACE inhibitor. The nurse plans to contact the health care provider if the client is also taking which medication? a. docusate sodium (Colace) d. spironolactone (Aldactone) A client is prescribed a noncardioselective beta1 blocker. What nursing intervention is a priority for this client? a. Assessment of blood glucose levels b. Respiratory assessment Which client will the nurse assess first? a. The client who has been on beta blockers for 1 day. c. The client who has stopped taking a beta blocker due to cost. The nurse is caring for a client with hypertension who is prescribed Clonidine transdermal preparation. What is the correct information to teach this client? a. Change the patch daily at the same time. d. Get up slowly from a sitting to a standing position. A calcium channel blocker has been ordered for a client. Which condition in the client's history is a contraindication to this medication? a. Hypokalemia The client taking Methyldopa (Aldomet) has elevated liver function tests. What is the nurse's best action? a. Document the finding and continue care. b. Notify the health care provider. A client taking prazosin has a blood pressure of 140/90. The client is complaining of swollen feet. What is the nurse's best action? a. Hold the medication. c. Determine the client's history. A client who takes clonidine (Catapres) is to be discharged to home. Which instruction will the nurse include when teaching this client? a. "Your blood pressure should be checked by a health care provider at least once a year." b. "Increasing fluid and fiber in your diet can help prevent the side effect of constipation." Which is a priority nursing diagnosis for a client taking an antihypertensive medication? a. Alteration in cardiac output
related to effects on the sympathetic nervous system a. Alteration in cardiac output related to effects on the sympathetic nervous system The
nurse is teaching the client diagnosed with angina about sublingual Nitroglycerin. Which statement indicated the client needs more medication teaching? 5. The client
diagnosed with angina is prescribed nitroglycerin and tells the nurse, "I don't understand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurses best response? 6.The client diagnosed with a myocardial infarction is receiving thrombolytic therapy. Which data warrants immediate intervention by the nurse? 8. The client being discharged after sustaining an acute myocardial infarction is prescribed the ACE inhibitor lisinopril. Which instruction should be included when teaching about this medication? A patient with stable angina uses a nitroglycerin transdermal patch, and efforts are being made to prevent drug tolerance. Which statement made by the patient best demonstrates an understanding of the transdermal patch? “I will apply my patch at 8:00 AM and remove it at 8:00 PM.” A patient comes to the clinic for a follow-up appointment after being released from the hospital for angina. The nurse is discussing his medication, nitroglycerin. The nurse is correct to state that the principal way this medication relieves the pain of
stable angina is by reducing cardiac oxygen demand. The nurse understands that to reduce tolerance to nitrates in a patient with stable
angina, the patient should be dosed with sustained-release oral tablets on an intermittent schedule. The nurse is
caring for a patient who begins to complain of shortness of breath. Upon further assessment, the nurse notes 3+ pitting edema bilaterally in the lower extremities. Which medication taken by the patient would most concern the nurse with regard to these findings? Oprelvekin (interleukin-11) After receiving patient education about erythropoietin, the patient states that for the medication to be effective, the body must have sufficient amounts of which of the folllowing? (Select all that apply.) Folic Acid, Vitamin B12, and Iron patient is being evaluated in the emergency department for complaints of severe chest pain. The ECG confirms an ST-elevation myocardial infarction (STEMI). Which drug would the nurse anticipate administering for the relief of chest pain? A patient who comes to the emergency department is anxious, short of breath, diaphoretic, and has a history of heart disease. The patient states that the doctor instructed him to chew an aspirin on the way to the emergency department. The nurse understands that the rationale for this instruction is that aspirin suppresses platelet aggregation, producing an immediate antithrombotic effect. What is the action of Antianginals?Antianginal drugs may effectively relieve or prevent acute ischemic episodes by increasing myocardial oxygen supply, decreasing myocardial oxygen demand, or both.
Are beta blockers Antianginals?In view of these findings it is suggested that a beta1 selective blocker may be a more efficient antianginal agent than a nonselective blocker in those patients in which the anginal attack is associated with a significant release of adrenaline.
What is the purpose of antianginal pharmacotherapy?Antianginal drugs are used primarily to restore the balance between the oxygen supply and demand of the heart. These drugs dilate the coronary vessels to increase the flow of oxygen to the ischemic regions. Other than that, they also decrease the workload of the heart so the organ would have less demand for oxygen.
How can antianginal drugs help decrease the workload of the heart and reduce angina?Calcium channel blockers dilate arteries, decrease the force of the heart's contractions, and lower blood pressure. They also dilate veins, reducing the amount of blood returning to the heart, which reduces the workload of the heart.
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