The nurse is listening to a 56-year-old client's apical heart ...

[ereecah]

The nurse is listening to a 56-year-old client's apical heart rate before giving digoxin (Lanoxin) and notes that the heart rate is 48 beats/min. Which of the following would be an appropriate course of action taken by the nurse?
 
  1. Withhold the digoxin, and reevaluate the heart rate in 4 hours.
  2. Administer half the prescribed dose to avoid a further decrease in heart rate.
  3. Withhold the digoxin; assess for signs of decreased cardiac output and digoxin toxicity.
  4. Administer the digoxin; the heart rate would be considered normal because of the client's age.

Question 2

The nurse reading the operative record of a client who had cardiac surgery notes that the client's cardiac output immediately after surgery was 3.2 L/min.
 
  Evaluation of the cardiac output results leads the nurse to make which of the following conclusions? 1. The cardiac output is above the normal range.
  2. The cardiac output is in the high-normal range.
  3. The cardiac output is in the low-normal range.
  4. The cardiac output is below the normal range.

[asware1]

Answer to Question 1

3

Rationale: The normal heart rate is 60 to 100 beats/min in an adult. If the nurse notes a heart rate that is less than 60 beats/min, the nurse would not administer the digoxin and would further evaluate the client for signs and symptoms of digoxin toxicity. When clients are bradycardic, they may have symptoms of decreased cardiac output so this would also be assessed.

Answer to Question 2

4

Rationale: The normal cardiac output for the adult can range from 4 to 7 L/min. Therefore a cardiac output of 3.2 L/min is below normal range.

[ereecah]

Excellent

[bbburns21]

TYSM