Answer to Question 1
ANS: D
With low potassium levels (ie, below 3.5 mEq/L), which can occur secondary to furosemide administration, the risk of digoxin-induced toxicity is greatly increased. The apical pulse must be monitored, and digoxin should not be administered to a patient with a pulse below 60/minutes.
Crackles and respirations of 22/minute would be indications for furosemide and digoxin therapy and therefore not a concern for the nurse related to administration.
A digoxin level of 0.5 mg/dL is considered therapeutic, therefore digoxin should be continued with no concern.
A blood pressure of 140/90 would not be affected by digoxin and may actually be helped by furosemide, which would reduce volume and thus help reduce blood pressure.
Answer to Question 2
ANS: B
Spironolactone (Aldactone) blocks the action of aldosterone in the distal nephron and benefits patients with severe heart failure. Aldosterone acts to promote sodium uptake in exchange for potassium secretion; it therefore increases the excretion of sodium, promoting diuresis.
Spironolactone increases, rather than decreases, the excretion of sodium.
Spironolactone does not redistribute edema; rather, it is used to help reduce edema.
Spironolactone spares potassium removal rather than increasing its excretion.
The patient interview often requires note taking.
Apply direct pressure to the patient’s wound.
Algorithm for assessing a patient at risk for self-directed violence.
Examples of endocrine disorders. (D) A patient with gigantism.
Medical Gymnasts Assist Patient in Performing Movements, 1909.