NURS 3210 ALG 3

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Questions and Answers

What is the priority for regular assessment when a patient is taking thiazide diuretics and digoxin concurrently?

Maintaining potassium levels within normal values to prevent hypokalemia and decrease the risk of digoxin toxicity.

What is a potential side effect of thiazide diuretics that can increase the risk of digoxin toxicity?

Hypokalemia

What should the nurse monitor for to assess for digoxin toxicity in a patient taking thiazides and digoxin?

Signs and symptoms such as altered oxygenation, decreased cardiac output, dizziness, lightheadedness, weakness, fatigue, tremor, muscle cramping, changes in mental status, or cold, clammy skin.

What is the rationale for monitoring potassium levels in a patient taking thiazide diuretics and digoxin?

To prevent hypokalemia, which can increase the risk of digoxin toxicity. Signup and view all the answers

What is a human need statement related to thiazide diuretic therapy?

Altered fluids, decreased, related to drug effects and adverse effects of diuretics. Signup and view all the answers

What should the nurse include in the plan of care to monitor for potential problems with diuretic therapy?

Measure and document blood pressure, pulse rate, intake, output, and daily weights. Signup and view all the answers

What is a potential complication of thiazide diuretic therapy?

Postural hypotension and dizziness. Signup and view all the answers

Why is it important to monitor for hypokalemia in a patient taking thiazide diuretics and digoxin?

To prevent digoxin toxicity, which can occur when potassium levels are low. Signup and view all the answers

What is the importance of daily weights in heart failure management?

Daily weights are important to monitor for weight gain, which can be a sign of fluid buildup and worsening heart failure. Signup and view all the answers

What should patients with heart failure avoid doing when their condition improves with therapy?

Abruptly stopping their medication Signup and view all the answers

Why is it crucial to supervise medication regimens for older adults and physically or mentally challenged patients?

To prevent adverse effects, toxicity, and drug interactions. Signup and view all the answers

What is the priority in a situation where a patient develops a severe heart block dysrhythmia due to digoxin overdose?

Stabilizing the patient Signup and view all the answers

What should a patient report to their healthcare provider regarding their heart rate?

Any palpitations, rapid heart rate, irregular heart rate, or changes in heart rate. Signup and view all the answers

What is the benefit of keeping a daily journal for patients with heart failure?

To track medications, daily weights, dietary intake, and any adverse effects or changes in condition. Signup and view all the answers

What is the indication for digoxin immune Fab therapy in cases of digoxin toxicity?

Hyperkalemia, life-threatening cardiac dysrhythmias, and life-threatening digoxin overdose Signup and view all the answers

What is the mechanism of action of digoxin immune Fab in treating digoxin toxicity?

It forms an antigen-antibody complex with digoxin, inactivating the free digoxin Signup and view all the answers

Why is it essential for patients to wear a medical alert bracelet or necklace?

To ensure emergency responders have access to critical medical information in case of an emergency. Signup and view all the answers

Why is it essential to reinforce the fact that certain medications should not be abruptly stopped?

To avoid the risk of hypertensive rebound Signup and view all the answers

What should a patient do if they miss a dose of digoxin?

Take the omitted dose if no more than 12 hours have passed from the time the drug was to have been taken. Signup and view all the answers

What is the importance of frequent updates to medical information and medication lists?

To ensure accuracy and relevance of information for healthcare providers and emergency responders. Signup and view all the answers

What is the role of atropine in managing severe heart block dysrhythmia?

It is used to treat bradycardia, but may not be effective in all cases Signup and view all the answers

How could the situation of digoxin overdose have been prevented?

By administering the correct dosage of digoxin Signup and view all the answers

What is the purpose of instructing patients to report changes in vision?

To detect potential adverse effects of digoxin, such as vision changes. Signup and view all the answers

What is the maximum dosage of digoxin considered safe for adult patients?

Less than 10 mg Signup and view all the answers

What laboratory values would you need to monitor while a patient is receiving milrinone?

Serum laboratory values such as potassium, sodium, magnesium, and calcium levels, Electrocardiogram (ECG), Results of renal function tests, and Results of liver function tests. Signup and view all the answers

Why must furosemide not be injected into intravenous lines with milrinone?

It will precipitate immediately. Signup and view all the answers

What should a patient with heart failure be taught to monitor while recovering at home?

Their medications and signs of heart failure exacerbation. Signup and view all the answers

What is a potential problem when administering furosemide and milrinone concurrently?

Crystalization/precipitation. Signup and view all the answers

What is a concern with co-administering digoxin and milrinone?

Additive inotropic effects. Signup and view all the answers

What laboratory values are important to monitor in heart failure management?

BNP and NT-proBNP levels. Signup and view all the answers

What is the rationale for monitoring serum potassium levels in patients taking milrinone?

To prevent hypokalemia. Signup and view all the answers

Why is it essential to monitor renal function tests in patients taking milrinone?

To prevent kidney damage. Signup and view all the answers

What instruction should be given to the patient if more than 12 hours have passed since the missed dose of digoxin?

The patient should not skip that dose, not double up on the next digoxin dose, and contact the prescriber immediately for further instructions. Signup and view all the answers

Why is it essential to educate patients on common side effects of angiotensin receptor-neprilysin inhibitors (ARNis)?

To monitor for side effects of hypotension, hyperkalemia, and increased serum creatinine, and to report any worsening of dizziness or dyspnea. Signup and view all the answers

What should be encouraged in patients taking potassium-depleting diuretics?

Consuming foods high in potassium and reporting any weakness, fatigue, or lethargy. Signup and view all the answers

Why should patients avoid certain foods and antacids when taking medications for heart failure?

To avoid interference with the absorption of the oral dosage forms of these medications. Signup and view all the answers

What is the importance of regular monitoring of serum potassium, renal functioning, and blood pressure in patients taking ARNis?

To detect potential side effects of hypotension, hyperkalemia, and increased serum creatinine. Signup and view all the answers

Why is it crucial to instruct patients not to abruptly stop medications for heart failure?

To prevent worsening of heart failure symptoms and potential complications. Signup and view all the answers

What should patients report to their healthcare provider regarding their heart rate?

Any unusual problems, worsening of dizziness or dyspnea, or unusual symptoms. Signup and view all the answers

Why is it essential to supervise medication regimens for older adults and physically or mentally challenged patients?

To ensure adherence to treatment and prevent potential complications. Signup and view all the answers

Study Notes

Pharmacology and Nursing

Successful therapy requires lifelong medication, and patients should never abruptly stop taking medication due to the risk of hypertensive rebound.

Digoxin Therapy

Digoxin immune Fab may be indicated in cases of significant toxicity, including hyperkalemia, life-threatening cardiac dysrhythmias, and severe sinus bradycardia or heart block unresponsive to atropine treatment or cardiac pacing.
Digoxin immune Fab is an antibody that recognizes digoxin as an antigen and forms an antigen-antibody complex with the drug, thus inactivating the free digoxin.

Thiazide Diuretics and Digoxin Interaction

Thiazide diuretics can increase digoxin toxicity, and the nurse should prioritize regular assessment of potassium levels to prevent hypokalemia.
The signs and symptoms of toxicity to monitor for include altered oxygenation, decreased cardiac output, altered fluids, and altered safety needs.

Patient Education and Monitoring

Patients should be instructed on how to take their radial pulse before each dose of digoxin and to report any changes in heart rate, palpitations, or irregular heart rate.
Patients should keep a daily journal to track medications, daily weights, dietary intake, and any adverse effects or changes in condition.
Patients should wear a medical alert bracelet or necklace and carry a current medication and medical history card.

Medication Administration

Digoxin is usually taken once a day, and patients should take it at the same time every day.
If a dose is missed, patients may take the omitted dose if no more than 12 hours have passed from the time the drug was to have been taken.
Patients should not abruptly stop taking medications, and if problems occur, they should contact their prescriber.

Angiotensin Receptor-Neprilysin Inhibitors (ARNis) and Potassium-Depleting Diuretics

Patients taking ARNis should be educated about the common side effects of hypotension, hyperkalemia, and increased serum creatinine.
Patients taking potassium-depleting diuretics should consume foods high in potassium and report any weakness, fatigue, or lethargy.

Diuretics in Heart Failure and Renal Failure

Diuretics are an important part of therapy for conditions like heart failure or renal failure because they may increase heart rate and have positive chronotropic effects.
Laboratory values to monitor while receiving diuretics include serum potassium, sodium, magnesium, and calcium levels, as well as electrocardiogram (ECG) results and renal function tests.

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Description

Learn about the importance of lifelong therapy and the risks of abruptly stopping medication in pharmacology and nursing.