Which nursing action is a priority before administering prescribed furosemide?
2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. Show 2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion and administer the warfarin sodium as prescribed. A client is diagnosed with an ST-segment elevation myocardial infarction (STEMI) and is receiving tissue plasminogen activator, alteplase (Activase, tPA). Which action is a priority nursing intervention? 3. Monitor for signs of bleeding. The nurse is planning to administer hydrochlorothiazide to a client. The nurse understands that which is a concern related to the administration of this medication? 3. Hypokalemia, hyperglycemia, sulfa allergy The 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 statement, by the client, indicates the need for further education? 4. "I'll continue my nicotinic acid from the health food store." The nurse is monitoring a client who is taking digoxin (Lanoxin) for adverse effects. Which findings are characteristic of digoxin toxicity? Select all that apply.
Prior to administering a client's daily dose of digoxin, the nurse reviews the client's laboratory data and notes the following results: serum calcium, 9.8 mg/dL; serum magnesium, 1.2 mg/dL; serum potassium, 4.1 mEq/L; serum creatinine, 0.9 mg/dL. Which result should alert the nurse that the client is at risk for digoxin toxicity? A client being treated for heart failure is administered intravenous bumetanide. Which outcome indicates the medication has achieved the expected effect? 4. Urine output increases from 10 mL/hour to greater than 50 mL hourly Intravenous heparin therapy is prescribed for a client. While implementing this prescription, the nurse ensures that which medication is available on the nursing unit? A client is prescribed nicotinic acid (niacin) for hyperlipidemia and the nurse provides instructions to the client about the medication. Which statement by the client indicates an understanding of the instructions? 4. "Ibuprofen (Motrin) taken 30 minutes before the nicotinic acid should decrease the flushing." The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan (Avapro) has been prescribed for the client. The nurse should suspect that the client has which condition? The home care nurse instructs a client on how to administer enoxaparin (Lovenox) subcutaneously. Which statement, if made by the client, indicates an understanding of how to administer this medication? 3. "A syringe that has a small ⅝-inch needle is used to administer the injection." A client is scheduled for a dose of ramipril (Altace). The nurse should check which measurement before administering the medication? The clinic nurse is providing instructions to a client with hypertension who will be taking captopril (Capoten). Which statement by the client indicates a need for further instruction? 3. "I need to drink at least 4 quarts of water daily." A thrombolytic is administered in the hospital emergency department to a client who has had a myocardial infarction. The client's spouse asks the nurse about the purpose of the medication. The nurse bases the response on which fact regarding this medication? 3. Thrombolytics act to dissolve thrombi that have already formed. A client who had surgery 3 days earlier is receiving heparin sulfate by subcutaneous injection every 12 hours. In planning for the client's morning care, the priority nursing intervention is which action? 2. Assist the client to shave using an electric razor. A client scheduled to take a subcutaneous anticoagulant at home says to the nurse, "I'm not sure I will be able to take this medication at home." Which statement by the nurse is most appropriate? 3. "What are your concerns about taking this medication at home?" A client is being discharged on warfarin sodium (Coumadin), and the nurse provides instructions to the client regarding the medication. Which statement, if made by the client, indicates to the nurse that the client understands the teaching provided? 4. "If I notice blood-tinged urine, I will call the health care provider." A client receives education regarding self-administration of enoxaparin (Lovenox) on discharge to home. The client complains, "I feel as if the health care provider is discharging me too soon if I still have to take injections at home." What is the best nursing response? 4. "Research shows that it is best for clients to administer this medication at home rather than stay in the hospital." The nurse is caring for a client who is taking warfarin (Coumadin), an oral anticoagulant. The nurse notes the presence of gross hematuria and large areas of bruising on the client's body. The nurse notifies the health care provider and ensures that which prescribed medication is available? 3. Phytonadione (vitamin K) The home care nurse has given instructions to a client who is beginning therapy with digoxin (Lanoxin). The nurse determines a need for further teaching of the instructions if the client makes which statement? 1. "If I miss a dose, I should just take two the next day." A client who began medication therapy with prazosin hydrochloride (Minipress) 1 week earlier arrives at the health care clinic for follow-up evaluation and care. The nurse interprets that the client is experiencing the expected benefit of therapy if which is noted? 3. Decreased blood pressure A hypertensive client has been prescribed clonidine hydrochloride (Catapres-TTS), a transdermal patch. The nurse provides written instructions to the client on the use of the patch. Which statement by the client indicates the need for further instruction? 1. "I need to change the patch every 24 hours." A client with hypertension has begun taking spironolactone (Aldactone). The nurse teaches the client to limit intake of which food? A client with hypertension has a new prescription for a medication called moexipril (Univasc). The nurse plans to provide written directions that tell the client to take the medication at which time? A health care provider (HCP) prescribes warfarin sodium (Coumadin) for a client. The home care nurse visits the client at home and teaches the client about the medication and its administration. Which statement by the client indicates a need for further teaching? 1. "The urine normally changes to orange." The nurse has been given a medication prescription to administer intravenous (IV) hydralazine (Apresoline). The nurse obtains which priority piece of equipment needed for use during administration of this medication? 3. Noninvasive blood pressure cuff The nurse is reviewing the assessment findings for a client who has been taking spironolactone (Aldactone) for treatment of hypertension. Which, if noted in the client's record, would indicate that the client is experiencing an adverse effect related to the medication? 3. A potassium level of 5.8 mEq/L The nurse is providing instructions to a client with chronic atrial fibrillation who is being started on quinidine sulfate. The nurse should plan to provide which instruction to the client? 1. Wear a Medic-Alert bracelet. The nurse notes a persistent, dry cough in an adult client being seen in the ambulatory clinic. When questioned, the client states that the cough began approximately 2 months ago. On further assessment, the nurse learns that the client began taking quinapril (Accupril) shortly before the time that the cough began. How should the nurse interpret the development of the cough? 4. An expected although bothersome side effect of therapy A client with angina pectoris has been given a new prescription for nitroglycerin transdermal patches. The client indicates an understanding of how to use this medication administration system by making which statement? 4. "I need to apply the patch in the morning and leave it in place for 12 to 14 hours as directed." A client in the hospital emergency department who received nitroglycerin for chest pain has obtained relief but now complains of a headache. The nurse should interpret that this client is most likely experiencing which condition? 1. An expected medication side effect A client who has begun taking betaxolol (Kerlone) demonstrates an effective response to the medication as indicated by which nursing assessment finding? 4. Decrease in blood pressure from 142/94 mm Hg to 128/82 mm Hg A client who is taking chlorothiazide (HydroDIURIL) comes to the clinic for periodic evaluation. In monitoring the client's laboratory test results for medication side effects, what is the clinic nurse most likely to note if a side effect is present? A client is taking amiloride (Midamor) 10 mg orally daily. What medication instruction should the nurse provide to the client? 3. Take the dose in the morning. Lisinopril (Prinivil) has been prescribed for a client. What should the nurse instruct the client to do? 3. Rise slowly from a reclining to a sitting position. A health care provider (HCP) prescribes quinidine gluconate for a client. The nurse decides to withhold the medication and contact the HCP if which assessment finding is documented in the client's medical record? 4. Complete atrioventricular (AV) block A client is to be discharged from the hospital on quinidine gluconate to control ventricular ectopy. The nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? 3. "I need to stop the medication immediately if diarrhea, nausea, or vomiting occurs." A client has been prescribed pindolol (Visken) for hypertension. The nurse provides anticipatory guidance, knowing that which common side effect of this medication may decrease client compliance? A client receiving total parenteral nutrition (TPN) has a history of heart failure. The health care provider has prescribed furosemide (Lasix) 40 mg by mouth daily to prevent fluid overload. Which laboratory value should the nurse monitor to identify the presence of an adverse effect from this medication? A client with heart failure is scheduled to be discharged to home with digoxin (Lanoxin) and furosemide (Lasix) as daily prescribed medications. The nurse tells the client to report which finding as an indication that the medications are not having the intended effect? 2. Weight gain of 2 to 3 lb in a few days A client with pulmonary edema has a prescription to receive morphine sulfate intravenously. The nurse should determine that the client is experiencing an intended effect of the medication as indicated by which assessment finding? 2. Relief of apprehension The nurse has provided instructions to a client receiving enalapril maleate (Vasotec). Which statement by the client indicates a need for further instruction? 2. "I need to notify the health care provider if fatigue occurs." A health care provider writes a prescription for lisinopril (Zestril) for a hospitalized client. The nurse caring for the client determines that the medication has been prescribed to treat which disorder? A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports that he has a dry, nonproductive cough that is very bothersome. The nurse should respond by making which statement? 1. The medication may need to be changed. The home care nurse visits a client with a diagnosis of unstable angina. The client is taking acetylsalicylic acid (aspirin) on a daily basis to reduce the risk of myocardial infarction (MI). Which medication dose would the nurse expect the client to be taking? The nurse prepares to teach a client with subarachnoid hemorrhage about the effects of nimodipine. The nurse plans to explain which information about the purpose of this medication? 4. Calcium channel blocker that will decrease spasm in cerebral blood vessels A client is being treated for moderate hypertension and has been taking diltiazem (Cardizem) for several months. The client schedules an appointment with the health care provider because of episodes of chest pain, and Prinzmetal's angina is diagnosed. The nurse understands that this medication will provide which therapeutic effect for this new diagnosis? 3. Prevents influx of calcium ions in vascular smooth muscle4.Leads to an increase in calcium absorption in the vascular smooth muscle A client with chronic atrial fibrillation is being started on quinidine sulfate (Quinidine) as maintenance therapy for dysrhythmia suppression, and the nurse provides instructions to the client about the medication. Which statement by the client indicates a need for further instruction? 4. "I will stop taking the prescribed anticoagulant after starting this new medication." Fenofibrate (Tricor) is prescribed for a client with hyperlipidemia. The nurse reviews the client's medical history for the presence of what condition that contraindicates the use of this medication? 3. Cirrhosis of the liver Acetylsalicylic acid (ASA), or aspirin, has been prescribed for a client with angina, and the client asks the nurse how the medication will help. The nurse responds that this medication has been prescribed for which purpose? 3. Inhibit platelet aggregation. A nurse is collecting data from a client and notes that the client is taking atenolol (Tenormin). What has this medication been prescribed to treat? Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should the nurse respond regarding the action of this medication? The health care provider (HCP) writes a prescription for atenolol (Tenormin) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 2. Apical heart rate is 48 beats/min. Atenolol (Tenormin) has been prescribed for a hospitalized client. The nurse should check which item before administering this medication? Atenolol (Tenormin) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is an occasional side effect of this medication? A client admitted to the hospital is taking atenolol (Tenormin). The nurse monitors the client for which sign or symptom of an adverse effect of the medication? Atenolol (Tenormin) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 2. "If I feel that my heart rate is too low, I should stop the medication." A nurse is collecting subjective and objective data from a client and notes that the client is taking atorvastatin (Lipitor). What should the nurse determine that this medication has been prescribed to specifically treat? Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the action of the medication. How should nurse respond about the action of this medication? 3. Decreases low-density lipoproteins (LDLs) The health care provider (HCP) writes a prescription for atorvastatin (Lipitor) for a client who was admitted to the hospital. The nurse contacts the HCP to verify the prescription if which finding is noted in the assessment data? 3. Cirrhosis of the liver Atorvastatin (Lipitor) has been prescribed for a client. The nurse tells the client that which blood test will be done periodically while the client is taking this medication? 2. Liver function studies Atorvastatin (Lipitor) has been prescribed for a client, and the client asks the nurse about the side effects of the medication. What should the nurse tell the client is a frequent side effect of this medication? A client seen in the health care clinic for follow-up care is taking atorvastatin (Lipitor). The nurse should assess the client for which adverse effect of the medication? Atorvastatin (Lipitor) has been prescribed for a client, and the nurse provides instructions to the client about the medication. Which statement by the client indicates the need for further teaching? 3. "I won't need to adhere to a low-fat diet as long as I take this medication faithfully." Diltiazem (Cardizem) is prescribed for a client with Prinzmetal's variant angina. The nurse should plan care, knowing that this medication works by which method? 4. Inhibiting calcium movement across cell membranes of cardiac and smooth muscle A client with cardiac disease has begun taking propranolol (Inderal LA), and the nurse provides information to the client about the medication. The nurse should tell the client to contact the health care provider (HCP) if which symptoms develop? 3. Night cough and dyspnea Hydrochlorothiazide (HydroDIURIL) has been prescribed for a client. The nurse contacts the health care provider to verify the prescription if which condition is noted in the assessment data? 4. Allergy to sulfonamides A client is seen in the clinic complaining of anorexia and nausea. The health care provider suspects that the client may be experiencing digoxin toxicity. While waiting for test results to become available, the nurse should assess the client for which sign or symptom that would support a diagnosis of digoxin toxicity? The nurse is administering a dose of intravenous hydralazine (Apresoline) to a client. The nurse should ensure that which item is in place before injecting the medication? The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol (Betapace) orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side/adverse effect related to the medication? The nurse is caring for a client with hypertension receiving torsemide (Demadex) orally daily. Which laboratory test result would indicate to the nurse that the client may be experiencing an adverse effect related to the medication? 3. A potassium level of 3.1 mEq/L The nurse has given a client information about the use of nitroglycerin sublingual tablets. The client has a prescription for PRN use if chest pain occurs. Which client statement indicates an understanding of this medication? 2. "I need to discard unused tablets 6 to 9 months after the bottle is opened." A client is due for a dose of bumetanide. The nurse should temporarily withhold the dose and notify the health care provider (HCP) if which laboratory test result is noted? The nurse has given a client the prescribed dose of intravenous hydralazine (Apresoline). The nurse evaluates the effectiveness of the medication by monitoring which client parameter? The nurse has completed giving medication instructions to a client receiving benazepril (Lotensin). Which client statement indicates to the nurse that the client needs further instruction? 4. "I can use salt substitutes freely and eat foods high in potassium." The nurse has conducted medication instructions with a client receiving lovastatin (Mevacor). Which periodic blood study will be necessary and included in the client's instructions? 3. Liver function studies Daily administration of dipyridamole (Persantine) been prescribed for the client, and the nurse teaches the client about the medication. Which client statement indicates an understanding of the instructions? 4. "If I take this medicine with my Coumadin, it will protect my artificial heart valve." A client in the postpartum care unit who is recovering from disseminated intravascular coagulopathy is to be discharged on low dosages of an anticoagulant medication. In developing home care instructions for this client, the nurse should include which priority safety instruction regarding this medication? 2. Avoid taking acetylsalicylic acid (aspirin). Levothyroxine (Synthroid) is prescribed for a client diagnosed with hypothyroidism. The nurse reviews the client's record and notes that the client is presently taking warfarin (Coumadin). The nurse contacts the health care provider (HCP), anticipating that the HCP will prescribe which medication? 1. A decreased dosage of warfarin A nurse prepares to administer sodium polystyrene sulfonate (Kayexalate) to a client. Before administering the medication, the nurse reviews the action of the medication and understands that which is released by this medication? 3. Sodium ions in exchange for primarily potassium ions A home health nurse instructs a client about the use of a nitrate patch. The nurse should make which statement to the client to prevent client tolerance to nitrates? 2. "Have a 12-hour ‘no-nitrate' time." A client with nausea and bradycardia is admitted to a medical unit. The family hands a nurse a small white envelope labeled "heart pill." The envelope is sent to the pharmacy and it is found to be digoxin (Lanoxin). A family member states, "That health care provider doesn't know how to take care of my family." Which statement would convey a therapeutic response by the nurse? 2. "You are concerned your loved one receives the best care." A male client is on enalapril (Vasotec) for the treatment of hypertension. The nurse teaches the client that he should seek emergent care if he experiences which adverse effect? 4. Swelling of the tongue What should the nurse teach a client about an expected outcome of nesiritide (Natrecor) administration? 1. The client will have an increase in urine output. A client is admitted to a hospital with acute myocardial infarction and is started on tissue plasminogen activator (tPA, Activase) by infusion. Of the following parameters, which one should a nurse determine requires the least frequent assessment to detect complications of therapy with tPA? 3. Presence of bowel sounds A hospitalized client with coronary artery disease complains of substernal chest pain. After assessing the client's heart rate and blood pressure, a nurse administers nitroglycerin, 0.4 mg, sublingually. After 5 minutes the client states, "My chest still hurts." Which actions should the nurse take? Select all that apply.
A client has developed paroxysmal nocturnal dyspnea. Which medication should the nurse anticipate will be prescribed by the health care provider? A home health care nurse is visiting an older client at home. Furosemide (Lasix) is prescribed for the client and the nurse teaches the client about the medication. Which statement, if made by the client, indicates the need for further teaching? 3. "I need to drink lots of coffee and tea to keep myself healthy." In reviewing the medication records of the following group of clients, the nurse determines that which client would be at greatest risk for developing hyperkalemia? 3. Client receiving spironolactone (Aldactone) The nurse is caring for a client who is receiving dopamine. Which potential problem is a priority concern for this client? 2. Peripheral vasoconstriction The health care provider has prescribed clonidine (Catapres) for a client with hypertension. The nurse should inform the client that which is a side effect of this medication? Gemfibrozil (Lopid) is prescribed for a client. Which laboratory finding should alert the nurse about the need to withhold the medication and contact the health care provider? 3. Elevated liver function tests A nurse is caring for a client with hyperlipidemia who is taking cholestyramine (Questran). Which nursing assessment is most significant for this client relative to the medication therapy? 2. Auscultate bowel sounds. A nurse should educate the client receiving pravastatin (Pravachol) to immediately report which finding? The nurse has completed medication administration that included a nitroglycerin. Within minutes, the client is complaining of a headache. Which is the priority nursing action at this time? 3. Administer the prescribed analgesic. A client is admitted to the emergency department with a diagnosis of myocardial infarction (MI). The health care provider (HCP) prescribes the administration of alteplase (Activase). To achieve the best therapeutic outcome, the nurse understands this medication must be administered at which time? 1. Within 4 to 6 hours after onset of chest pain The nurse is preparing to administer furosemide (Lasix) to a client with a diagnosis of heart failure. Which is the most important laboratory test result for the nurse to check before administering this medication? The nurse is preparing to administer furosemide (Lasix) 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period? A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure? What are the contraindications for furosemide?Contraindications. Use of a higher than the recommended dose of furosemide or a fast infusion rate of the drug,. Hypoalbuminemia comorbid illnesses.. The concomitant use of ethacrynic acid, aminoglycosides, or other ototoxic drugs.. Patients with underlying severe renal impairment.. What is the indication of furosemide?Furosemide is indicated for the treatment of edema associated with congestive heart failure, cirrhosis of the liver, and renal disease, including the nephrotic syndrome, in adults and pediatric patients.
What is the priority nursing assessment for a client who is about to begin digoxin therapy?A nurse should assess the apical pulse for a full minute before administering digoxin due to its positive inotropic action (it increases contractility, stroke volume, and, thus, cardiac output), negative chronotropic action (it decreases heart rate), and negative dromotropic action (it decreases electrical conduction ...
Which medication should the nurse be prepared to administer to lower the patient's potassium level?Insulin administered intravenously has the fastest onset of action and is very effective in reducing serum potassium. β2-Adrenergic agonists are as effective as insulin for lowering serum potassium and have a longer duration of action.
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