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NURS 1240 Pharmacology Medical Surgical Drugs Case Study EAQ with complete solution

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NURS 1240 Pharmacology Medical Surgical Drugs Case Study EAQ with complete solution Digoxin is prescribed for a client with heart failure. The nurse will assess for which clinical manifestation that indicates digoxin toxicity? Select all that apply - Confusion - Headache - Nausea - Yellow ...

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  • July 26, 2023
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  • 2022/2023
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NURS 1240 Pharmacology Medical Surgical Drugs Case
Study EAQ with complete solution

Digoxin is prescribed for a client with heart failure. The nurse will assess for
which clinical manifestation that indicates digoxin toxicity? Select all that apply
- Confusion
- Headache
- Nausea
- Yellow vision
- Dizziness
- Irregular pulse
- Increased urine output
- Decreased respiratory rate
Confusion
Headache
Nausea
Yellow vision
Dizziness
Irregular pulse

rationale: Signs and symptoms of digoxin toxicity include confusion, headache, nausea,
bradycardia, visual disturbances (blurred vision or yellow vision), and dizziness. In
addition, electrocardiogram (ECG) findings may include heart block, atrial tachycardia
with block, or ventricular dyschythmias, all causing an irregular pulse. Increased urine
output is an expected effect of improved cardiac output. Changes in respiratory rate,
slow or fast, are not associated with digoxin toxicity.
A client receiving chemotherapy develops bone marrow suppression. The nurse
will monitor for which thrombocytopenic effect? Select all that apply.
- Fatigue
- Pale skin
- Deep vein thrombosis
- Dizziness
- Melena
- Purpura
- Emboli
- Hematuria
Melena
Purpura
Hematuria

rationale: Bone marrow suppression results in a reduced number of circulating white
and red blood cells, as well as platelets. Black tarry feces caused by the action of
intestinal secretions on blood are associated with bleeding in the gastrointestinal tract;
bleeding is related to a reduced number of thrombocytes, which are part of the

, coagulation process. Hemorrhages into the skin and mucous membranes (purpura) may
occur with reduced numbers of thrombocytes, which are part of the coagulation
process. Blood in the urine (hematuria) may occur with a reduced number of
thrombocytes, which are part of the coagulation process. Signs of reduced red blood
cells, not platelets, include fatigue, pale skin, and dizziness.
Deep vein thrombosis and emboli are effects of thrombocytosis.
A client with hypertension is prescribed an angiotensin I receptor blocker
(ARB). Which instruction will the nurse provide about this medication? Select all
that apply.
- "Monitor the blood pressure often."
- "Discontinue treatment if a cough develops."
- "Stop the medication if swelling of the mouth, lips, or face develops."
- "Have blood drawn for potassium levels 2 weeks after starting the medication."
- "Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently with
this medication."
- "Notify other prescribers of new ARB prescription."
- "Report lightheadedness or dizziness upon standing to the provider."
- "Serum levels will be drawn at least once a month to ensure therapeutic levels."
- "Monitor the blood pressure often."
- "Discontinue treatment if a cough develops."
- "Stop the medication if swelling of the mouth, lips, or face develops."
- "Have blood drawn for potassium levels 2 weeks after starting the medication."
- "Notify other prescribers of new ARB prescription."
- "Report lightheadedness or dizziness upon standing to the provider."

rationale: The risk for hypotension is increased with ARB use, therefore the client
should be educated on the signs and symptoms of a low blood pressure and the need
to monitor blood pressure often. The medication should be stopped if angioedema
occurs, and the health care provider should be notified.
Electrolyte levels of potassium, sodium, and chloride should be obtained 2 weeks after
the start of therapy and then periodically thereafter. ARBs may increase the effects of
other medications such as antihypertensives and lithium, dosages may need to be
adjusted accordingly. A dry cough may occur during treatment with ARBs; however, it is
not necessary to discontinue the medication because the cough usually resolves. There
is no need to avoid the use of NSAIDs while taking an ARB. Serum levels are not
monitored with ARB use.
A health care provider prescribes aspirin therapy for a client with arthritis. The
nurse will advise the client to report which adverse effect immediately? Select all
that apply.
- Ongoing nausea
- Diarrhea
- Easy bruising
- Decreased pulse
- Sour stomach
- Ringing in the ears

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