The nurse is assessing an emergency department patient who was ...

[tuffie]

The nurse is assessing an emergency department patient who was recently discharged following a myocardial infarction (MI). Which symptom(s) would the nurse observe in this patient with left ventricular systolic failure? (Select all that apply.)
 
  a. Reports of recent weight loss
  b. Complaints of peripheral edema
  c. Diminished exercise tolerance
  d. Shortness of breath with activity
  e. Blood pressure elevation

Question 2

Which instruction by the nurse will be included when teaching an adult patient about digoxin (Lanoxin) for management of heart failure?
 
  a. Report nausea and vomiting to your health care provider.
  b. Decrease the amount of high potassium foods you eat.
  c. Omit your dose of digoxin if your pulse is 60 beats/min.
  d. Visual disturbances are common adverse effects.

[vboyd24]

Answer to Question 1

ANS: C, D
Early clinical symptoms of left ventricular failure are decreased exercise tolerance and poor perfusion to peripheral tissues. Patients who develop left ventricular systolic failure as a result of MI have acute shortness of breath. Weight gain is more likely to be reported because of edema in diastolic failure. Patients who develop left ventricular systolic failure as a result of MI have shock with little peripheral edema and hypotension.

Answer to Question 2

ANS: A
Nausea and vomiting are serious adverse effects indicative of toxicity. Low potassium levels can cause toxicity; adequate intake of potassium is necessary. The dose is withheld if the pulse rate is less than 60 beats/min in adults. Visual disturbances are not common adverse effects.

[tuffie]

TYSM

[Alyson.hiatt@yahoo.com]

Thanks for the timely response, appreciate it