A patient with a history of cardiac problems is admitted to a ...

[c0205847]

A patient with a history of cardiac problems is admitted to a telemetry unit. The prescriber orders digoxin (Lanoxin) at a high dose for 2 days, followed by a lower dose thereafter. What is the nurse's best action?
 
  a. Delay administration of the drug in order to discuss the prescription with the pharmacist.
  b. Question the prescriber about the two doses, recognizing that a potentially ha-zardous situation exists.
  c. Administer the drug per the prescription, recognizing that a loading dose, fol-lowed by a maintenance dose, is being given.
  d. In the interest of patient advocacy, seek a second prescriber's opinion before car-rying out the prescription.

Question 2

A patient in the emergency department has severe chest pain. The nurse administers morphine intravenously. The patient asks the nurse why morphine is given. Which response by the nurse is correct?
 
  a. Morphine helps by reducing anxiety and relieving pain.
  b. Morphine helps by reducing pain and dissolving clots.
  c. Morphine helps by relieving pain and lowering blood pressure.
  d. Morphine helps by relieving pain and reducing the cardiac oxygen demand.

[djofnc]

Answer to Question 1

C
The nurse should recognize that digoxin may be given using a loading dose to achieve a thera-peutic level quickly, followed by maintenance doses.
Delaying administration of the drug would prolong the patient's need for it.
Questioning the prescriber would not be the best action.
The nurse should consult with the prescriber first before going over her head; the nurse should follow the chain of command.

DIF: Cognitive Level: Application REF: p. 43
TOP: Nursing Process: Implementation
MSC: NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

Answer to Question 2

D
IV morphine is the treatment of choice for STEMI-associated pain. Besides relieving pain, it promotes vasodilation and reduces cardiac preload, which lowers the cardiac oxygen demand. It does not reduce anxiety, dissolve clots, or lower blood pressure.

[c0205847]

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[djofnc]

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