Question 1

A patient is prescribed inamrinone (Inocor)by continuous intravenous infusion.When you make rounds and assess the patient,the intravenous bag infusing is labeled (Primacor).What should you do?

Accepted Answer

The two drugs,Inocor and Primacor,are not the same,although both are positive inotropes.Their dosages and infusion rates are very different.The pharmacy has sent up the wrong drug or has labeled the infusion bag incorrectly.Either way,you must stop the existing infusion and clarify all of this with the prescriber first and then the pharmacy.

Question 2

A patient is to receive nesiritide (Natrecor).Which patient assessments must be checked before giving this drug? (select all that apply)

Accepted Answer

Nesiritide is given by the IV route,so you should always ensure that the IV line is patent.Heart and respiratory rate should always be assessed before giving this drug.The heart rate should be between 60 and 100 beats/min and the respiratory rate should be between 12 and 20 breaths/min.

Question 3

A patient with heart failure is receiving dobutamine (Dobutrex)intravenously at home.Which sign or symptom should the patient and family be instructed to report to the prescriber immediately?

Accepted Answer

Patients receiving dobutamine at home should be taught the signs and symptoms of IV lines that are no longer patent or have developed infection (e.g. ,burning,pain,redness,swelling,warmth at the site).Patients should be instructed to report these signs immediately to the prescriber or home health nurse.

Question 4

The patient is prescribed potassium (K-Dur)tablets 30 mg orally each morning.You have potassium (K-Dur)in 10 mg tablets.How many tablets will you give for each dose?

Accepted Answer

The answer of The patient is prescribed potassium (K-Dur)tablets 30...

Question 5

A patient has been prescribed sublingual nitroglycerin.Which key points will you teach the patient about this drug? (select all that apply)

Accepted Answer

Sublingual or buccal nitroglycerin should not be swallowed because the liver destroys most of the drug and makes it ineffective.The drug should be kept in place until it dissolved.Patients should not drink or eat until the tablet is dissolved.A tingling sensation as the tablet dissolves indicates that the drug is potent and any time a patient's chest pain persists after using one tablet,the prescriber should be notified.

Question 6

A patient who weighs 259 lb is prescribed to receive nesiritide (Natrecor)2 mcg/kg as an intravenous bolus.The drug available is 1.5 mg/5 mL.How many milliliters of the drug will you prepare to make the correct dose?

Accepted Answer

The answer of A patient who weighs 259 lb is...

Question 7

Which lifestyle changes should you suggest to a patient with heart failure? (select all that apply)

Accepted Answer

Lifestyle changes that are important in treating heart failure include weight loss,smoking cessation,and a low-salt and low-fat diet.A fluid restriction of 1000 mL can result in decreased perfusion of the kidneys.Patients with heart failure may not be able to tolerate an aerobic exercise program.

Question 8

Which are sympathetic nervous system compensatory mechanisms of the body for heart failure? (select all that apply)

Accepted Answer

The sympathetic nervous system releases the catecholamine hormones epinephrine and norepinephrine,which act on the heart in two ways.First they increase the heart rate,and second they increase the power of the heart muscle fibers to contract so that the heart pumps more forcefully.These actions increase cardiac output.

Question 9

A patient is prescribed digoxin (Lanoxin)0.03 mg as a liquid dose.The drug on hand is digoxin 0.05 mg/mL.How many milliliters do you give?

Accepted Answer

The answer of A patient is prescribed digoxin (Lanoxin)0.03 mg...

Question 10

What is the most important reason intravenous potassium is considered a high alert drug?

Accepted Answer

Blood potassium levels have a very narrow range of normal.When intravenous potassium is administered at too high a dose or too rapidly,life-threatening cardiac rhythm problems develop and death is possible.Always check an intravenous potassium dose with another health care professional and never administer it either by intravenous push or as a bolus.

Question 11

What should you teach a patient who has been prescribed potassium (K-Dur)tablets?

Accepted Answer

Common side effects of potassium include nausea,vomiting,diarrhea,gas,and abdominal discomfort.Taking the drug with food or right after meals with a full glass of water or fruit juice will decrease or prevent these side effects.A patient should never take a double dose of a prescribed drug.Most salt substitutes are made by replacing sodium with potassium.Use of salt substitutes or eating excessive amounts of foods that are high in potassium while taking a potassium supplement increases the risk of hyperkalemia (high blood potassium).

Question 12

A patient is receiving magnesium by intravenous infusion.Which finding indicates that the patient's blood magnesium level may be too high?

Accepted Answer

High blood levels of magnesium interfere with muscle contraction,causing muscle weakness.Breathing is dependent on good contraction of respiratory muscles.Shallow and slow respirations are a serious manifestation of excess blood magnesium levels.

Quiz 17: Drug Therapy for Heart Failure

A patient is prescribed inamrinone (Inocor) by continuous intravenous infusion.When you make rounds and assess the patient,the intravenous bag infusing is labeled (Primacor) .What should you do?

A patient is to receive nesiritide (Natrecor) .Which patient assessments must be checked before giving this drug? (select all that apply)

A patient with heart failure is receiving dobutamine (Dobutrex) intravenously at home.Which sign or symptom should the patient and family be instructed to report to the prescriber immediately?