Chapter 24: Heart Failure Drugs Test, Inotropic Drug, Pharmacology for Nurses: Practical
The key terms in this Pharmacology course include Heart Failure Drugs, Inotropic Drug, Pharmacology for Nurses: Practical Applications
For a patient receiving a positive inotropic drug, which nursing assessments should be performed? (Select all that apply.)
Auscultate lung sounds.
Monitor serum electrolytes.
Obtain daily weights.
Check apical pulse.
A patient prescribed digoxin 0.25 mg and furosemide 40 mg for the treatment of systolic heart failure states, “I am starting to see yellow halos around lights.” What is the appropriate nursing intervention?
Document the finding and reassess in 1 hour.
Perform a visual acuity test on each eye.
Assess for other symptoms of digoxin toxicity.
Prepare to administer digoxin immune fab.
Yellow-green halos around objects are a symptom of digoxin toxicity. Other signs and symptoms of digoxin toxicity include headache, dizziness, confusion, nausea, and blurred vision. Electrocardiogram findings show heart block, atrial tachycardia with block, or ventricular dysrhythmias.
A pediatric patient weighing 66 lb is prescribed digoxin 12 mcg/kg in 3 evenly divided doses a day. How much will the nurse administer per dose? __ Note: please provide your answer as xxx mcg for credit.
Correct Answer
120 mcg
To identify the dosage: 66 lb divided by 2.2 = 30 kg × 12 mcg/kg = 360 mcg/3 doses = 120 mcg/dose.
Phosphodiesterase inhibitors (PDIs) have an added advantage in treating heart failure. These drugs cause a positive inotropic effect and what other effect?
Vasoconstriction
Platelet inhibition
Bronchodilation
Vasodilation
PDIs are also called inodilators because they have both positive inotropic and vasodilatory effects.
The nurse would question the use of milrinone in a patient with which condition?
Systolic heart failure
Acute renal failure
Mitral valve prolapse
Aortic regurgitation
Milrinone, a PDI, is contraindicated in severe aortic or pulmonary valvular disease and in diastolic heart failure.
The patient’s serum digoxin level is 0.4 ng/mL. How does the nurse interpret this laboratory value result for digoxin?
Above the therapeutic level
Below the therapeutic level
A toxic serum blood level
Normal therapeutic level
Therapeutic serum digoxin levels are 0.5 to 2 ng/mL.
When teaching a patient regarding the administration of digoxin, the nurse instructs the patient not to take this medication with which food?
Scrambled eggs
French toast
Wheat bran
Bananas
Encourage patients to avoid using antacids or eating ice cream, milk products, yogurt, cheese (dairy products), or bran for 2 hours before or 2 hours after taking medication to avoid interference with the drugs absorption.