Class IA antiarrhythmic agents have little effect on:
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Solution
SA node
Class IA antiarrhythmics have little effect on the SA node.
Johanna has ventricular ectopy, which of the following drugs is the first line used to treat her condition?
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Solution
lidocaine (Xylocaine)
Lidocaine is the only choice used to treat ventricular ectopy. A and C are class IA antiarrhythmics. Digoxin is a cardiac glycoside.
Before giving milrinone (Primacor) by an IV infusion to a client with symptoms of CHF, which of the following nursing actions is necessary?
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Solution
Review medication regimen to identify if client is on IV furosemide (Lasix).
Milrinone (Primacor) is incompatible with IV furosemide (Lasix), and many clients with CHF are taking furosemide. Assessing potassium, not sodium, is essential. Choice B is not done before administration but during administration. Assessment of CV status is not specific for milrinone and is indicated for any drug that affects the circulatory system.
Blurred vision or halos are signs of:
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Solution
Digoxin toxicity
Halos is a hallmark sign of digoxin toxicity. A, C and D are incorrect because subtherapeutic digoxin levels have no such effects.
The therapeutic drug level for digoxin is:
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Solution
0.5-2.0 ng/mg
This is the correct therapeutic range for digoxin. Every nurse should know this information.
Which is the MOST appropriate action for the nurse to take before administering digoxin?
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Solution
Monitor potassium level
Monitoring potassium is especially important because hypokalemia potentiates digoxin toxicity. B and C are incorrect because these data reflect overall CV status but are not specific for digoxin. Choice D are drugs usually administered with digoxin.
The action of medication is inotropic when it:
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Solution
Increases the force of contraction
Inotropic drugs increase the force of contraction. Preload, not afterload, is decreased. Chronotropic drugs increase heart rate. Treatment of CHF is an indication for use not an action of inotropic drug.
Which of the following is a contraindication for digoxin administration?
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Solution
Heart rate below 60
The apical heart rate must be monitored during therapy with digoxin, and the drug held for pulse below 60 and above 120. Remember that digoxin lowers the heart rate; therefore, the choice that reflects a low heart rate is the best selection.
Which of the following clients is at greatest risk for digital toxicity?
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Solution
An 80-year-old client with CHF
Extremely old clients are at greater risk for digitalis toxicity. Remember when it comes to adversity, the very old and very young are always at highest risk.