Cardiac Nursing Interventions

Question 1

a patient should be positioned lying or sitting down when taking which drug for the first time?

a. digoxin
b. nitrates
c. calcium channel blockers
d. beta blockers

Answer 1

b. nitrate

Question 2

when offering sublingual nitrates, should offer what? and why?

Answer 2

offer water bc dryness may inhibit drug absorption

Question 3

stinging or biting sensation indicates that which kind of medication is ‘fresh’

Answer 3

SL nitrogylcerin tablets

Question 4

amber color glass provides protection for which kind of medication

Answer 4

SL nitroglycerin tablets, provides light protection

Question 5

if a patient is taking _______ and a potassium wasting diuretic or cortisone, then ________ may result, causing _______ __________

Answer 5

digoxin, hypokalemia, digoxin toxicity

low serum pottassium level enhances digoxin effects.

Question 6

patients taking a thiazide or cortisone with digoxin should take

Answer 6

a potassium supplement

Question 7

when administering digoxin, must ascertain what first before?

a. skin pallor
b. temperature
c. heart rate
d. O2 saturation

Answer 7

c. heart rate,

must not administer if less than 60 b/min

Question 8

when administering digoxin must look out for

Answer 8

peripheral and pulmonary edema which indicate heart failure

Question 9

the normal serum digoxin level is _____ ng/mL

a. 0.1-0.5
b. 0.5-0.8
c. 0.8-2
d. 2-2.5

Answer 9

.8-2 ng/mL

a serum level greater than 2 is indicative of digitalis toxicity

Question 10

which value must you report when administering digoxin

a. hyperkalemia
b. hypernatremia
c. hypokalemia
d. hyponatremia

Answer 10

hypokalemia

Question 11

advise patients to eat food high in ____ when teaching about digoxin

Answer 11

potassium

Question 12

foods that are high in potassium

Answer 12

fresh and dried fruits, fruit juices, vegetables, potatoes

Question 13

when administering antidsyrhythmics you must monitor which lab results?

Answer 13

cardiac enzyme results

aspartate aminotransferase, lactate dehydrogenase, creatine phosphokinase and troponins (cardiac specific)

Question 14

which kind of drug must be administered by IV push or bolus over a period of 2-3 minutes

a. antianginals
b. antihypertensives
c. antidysrhythmics
d. cardiac glycosides

Answer 14

antidysrthytmics

Question 15

increased Q-T interval is a risk factor for

Answer 15

torsades de pointes

Question 16

when administering antidysrhythmics, monitor ECG for abnormal patterns like

Answer 16

premature ventricular contractions (PVCs), increased PR and QT intervals, and/or widening of the QRS complex.

Question 17

The nurse is monitoring a patient during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action?

Blood pressure 110/90 mm Hg
Flushing
Headache
Chest pain

Answer 17

The patient should not continue to have chest pain while on IV nitroglycerin. This would prompt the nurse to intervene. Blood pressure of 110/90 mm Hg is not cause for concern and is expected with nitroglycerin. Headache and flushing are common side effects of nitroglycerin.

Question 18

how many tablets can patients take of nitroglycerin?

up to ____ tablets every ____ mins. if no relief is obtained after one, they should ________ and take up to _____ more tablets

Answer 18

Patients are taught to take up to three tablets every 5 minutes. If no relief from chest pain is obtained after one tablet, they should seek medical assistance and take up to two more tablets. All other responses demonstrate a good understanding by the patient.

Question 19

A patient 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?
Assess the patient’s lung sounds.
Decrease the intravenous nitroglycerin by 10 mcg/min.
Stop the nitroglycerin infusion for 1 hour and then restart.
Continue the infusion and recheck the patient’s vital signs in 15 minutes.

Answer 19

Nitroglycerin, as a vasodilator, causes a decrease in blood pressure. Because it is short-acting, decreasing the infusion rate will allow the blood pressure to rise. The patient should be monitored every 10 minutes while changing the rate of the intravenous nitroglycerin infusion.`

Question 20

A patient is being treated for short-term management of heart failure with milrinone (Primacor). What is the primary nursing action?
  Administer digoxin via IV infusion with the milrinone.
  Administer furosemide (Lasix) via IV infusion after the milrinone.
  Monitor blood pressure continuously. 
  Maintain an infusion of lactated Ringer’s with milrinone infusion.

Answer 20

Milrinone lactate (Primacor) is a phosphodiesterase inhibitor administered intravenously for short-term treatment in patients with heart failure not responding adequately to digoxin, diuretics, or other vasodilators. Blood pressure and heart rate should be closely monitored. Digoxin is not administered with the milrinone but is usually tried before treatment with milrinone. Furosemide is not necessarily administered after the milrinone, although it could be. It is not, however, administered routinely via IV infusion. Lactated Ringer’s does not have to be administered with milrinone.

Question 21

When titrating intravenous nitroglycerin for a patient, what is important for the nurse to monitor? (Select all that apply.)

Continuous oxygen saturation
  Continuous blood pressure 
  Hourly ECGs
  Presence of chest pain 
  Serum nitroglycerin levels 
  Visual acuity

Answer 21

ONLY continuous blood pressure and presence of chest pain