A nurse is preparing to assist a nursing student in administering ...

[SAVANNAHHOOPER23]

A nurse is preparing to assist a nursing student in administering intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient.
 
  Which statement by the student indicates a need for further teaching?
  a. I will check to see when the last dose of the beta blocker was given.
  b. I will monitor vital signs closely to assess for hypotension.
  c. I will monitor the heart rate frequently to assess for reflex tachycardia.
  d. I will prepare to administer intravenous norepinephrine if necessary.

Question 2

A nurse is caring for a patient who is receiving verapamil (Calan) for hypertension and digoxin (Lanoxin) for heart failure. The nurse will observe this patient for:
 
  a. AV blockade.
  b. gingival hyperplasia.
  c. migraine headaches.
  d. reflex tachycardia.

[diesoon]

Answer to Question 1

ANS: C
Reflex tachycardia is not an expected effect; the greater risk is cardiosuppression and bradycardia. Because beta blockers and verapamil have the same effects on the heart, there is a risk of excessive cardiosuppression. To minimize this risk, the two drugs should be given several hours apart. Hypotension may occur and should be treated with IV norepinephrine.

Answer to Question 2

ANS: A
Verapamil and digoxin both suppress impulse conduction through the AV node; when the two drugs are used concurrently, the risk of AV blockade is increased. Gingival hyperplasia can occur in rare cases with verapamil, but it is not an acute symptom. Verapamil can be used to prevent migraine, and its use for this purpose is under investigation. Verapamil and digoxin both suppress the heart rate. Nifedipine causes reflex tachycardia.

[SAVANNAHHOOPER23]

Thanks

[diesoon]

Welcome