A newly admitted patient diagnosed with heart failure has just ...

[james]

A newly admitted patient diagnosed with heart failure has just been started on an angiotensin-converting enzyme (ACE) inhibitor. He asks whether the drug will have a long-term effect on his general cardiovascular health.
 
  Which of the following responses from the nurse is most accurate?
  a. ACE inhibitors have been found to greatly reduce mortality, especially if you have a cerebrovascular accident.
  b. Suppression of angiotensin II seems to diminish over time, but ACE inhibitors also increase kinin release, which has a favorable effect on cardiac remodeling.
  c. We don't know whether ACE inhibitors have a long-term effect; however, this drug will help manage your heart failure at this time.
  d. No studies have demonstrated that ACE inhibitors have a long-term effect.

Question 2

A nurse is assessing a patient with a history of heart disease. The nurse records a pulse rate of 50. The nurse also observes cardiac dysrhythmias on the monitor, and the patient complains of seeing halos around lights.
 
  The nurse should prepare to administer
  a. Digibind.
  b. oxygen.
  c. naloxone (Narcan).
  d. vitamin K (Phytonadione).

[frejo]

Answer to Question 1

ANS: B
ACE inhibitors have a long-term positive effect, because they cause increased release kinin; this improves cardiac remodeling, which has been shown to reduce mortality with heart failure. Also, inhibition of angiotensin II for any length of time has a positive effect on cardiovascular health.
ACE inhibitors have little effect on the mortality of individuals with a history of CVA.
There is no concrete evidence that ACE inhibitors have a long-term effect regarding a positive or negative impact on cardiovascular and/or renal function. The evidence indicates the ACE inhibitors do have a significant positive effect on patients diagnosed with heart failure.
Studies have demonstrated that ACE inhibitors have a positive long-term effect.

Answer to Question 2

ANS: A
All signs and symptoms (low heart rate, seeing halos around lights, dysrhythmias) point to digoxin toxicity. The ability of digoxin to cause dysrhythmias in patients with heart disease is greatly increased. The nurse should suspect digoxin toxicity and administer Digibind.
Oxygen may be indicated, but it will not correct the dysrhythmias or reverse the toxicity.
Naloxone is indicated for opiate overdose, not digoxin toxicity.
Vitamin K is indicated for excessive bleeding, specifically for warfarin toxicity.

[james]

Thanks

[frejo]

Welcome