Antihypertensives and Cardiovascular Medications > Pharmacology
Exam Review
Medications for heart failure
Total Questions : 5
Showing 5 questions, Sign in for moreA nurse is caring for a client with heart failure who is receiving furosemide (Lasix). Which of the following findings should indicate to the nurse that the medication is effective?
Explanation
Furosemide (Lasix) is a diuretic that helps reduce fluid overload and edema in clients with heart failure.Increased urine output indicates that the medication is effective in removing excess fluid from the body and improving cardiac function.
Choice B is wrong because Decreased blood pressure is wrong because furosemide (Lasix) does not directly lower blood pressure, although it may have a mild effect due to reduced blood volume.Decreased blood pressure may also indicate hypovolemia, dehydration, or shock, which are complications of heart failure and diuretic therapy.
Choice C is wrong because Increased heart rate is wrong because furosemide (Lasix) does not affect the heart rate, unless the client develops electrolyte imbalances or hypovolemia, which can cause tachycardia.Increased heart rate may also indicate worsening heart failure, as the heart tries to compensate for reduced cardiac output.
Choice D is wrong because Decreased respiratory rate is wrong because furosemide (Lasix) does not affect the respiratory rate, unless the client develops respiratory depression or alkalosis, which are rare side effects of the medication.Decreased respiratory rate may also indicate fatigue, sedation, or opioid overdose, which are not related to heart failure or diuretic therapy.
Normal ranges for urine output are 30 to 60 mL/hr for adults, blood pressure is 120/80 mm Hg or lower for normal and 140/90 mm Hg or higher for hypertension, heart rate is 60 to 100 beats/min for adults, and respiratory rate is 12 to 20 breaths/min for adults.
A nurse is caring for a client who has heart failure and is receiving spironolactone (Aldactone). Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication? (Select all that apply)
Explanation
The correct answer is choice A. Hyperkalemia.Spironolactone is a potassium-sparing diuretic that prevents the body from absorbing too much salt and keeps the potassium levels from getting too low.However, this also means that it can cause high potassium levels (hyperkalemia) in some patients, especially those with kidney problems or taking other medications that affect potassium.Hyperkalemia can cause serious symptoms such as muscle weakness, irregular heartbeat, nausea, and paralysis.
Choice B is wrong becauseHypokalemia is wrong because spironolactone does not cause low potassium levels, but rather prevents them.
Choice C is wrong becauseGynecomastia is wrong because it is not a common adverse effect of spironolactone in women, but rather in men.Gynecomastia is the enlargement of breast tissue in males due to hormonal imbalance.
Choice D is wrong becauseMenorrhagia is wrong because it is not a common adverse effect of spironolactone in women, but rather in men.Menorrhagia is the excessive or prolonged bleeding during menstrual periods.
Choice E.Impotence is wrong because it is not a common adverse effect of spironolactone in women, but rather in men.Impotence is the inability to achieve or maintain an erection sufficient for sexual intercourse.
A client who has heart failure tells the nurse, “I have been taking my furosemide as prescribed, but I still feel short of breath.” Which of the following statements should the nurse make?
Explanation
You should notify your provider if you experience weight gain. This is because weight gain can indicate fluid retention, which can worsen heart failure and cause more shortness of breath. Furosemide is a diuretic that helps reduce fluid overload, but it may not be enough to control the symptoms of heart failure. Therefore, the provider may need to adjust the dose or add another medication.
Choice A is wrong because you should not increase your intake of foods high in potassium. Furosemide can cause potassium loss, but increasing potassium intake can lead to hyperkalemia, which can affect the heart rhythm and function. You should follow the provider’s advice on how much potassium to consume and have your potassium levels checked regularly.
Choice B is wrong because you should not decrease your intake of fluids. Dehydration can cause low blood pressure, kidney damage, and electrolyte imbalance, which can also affect the heart. You should drink enough fluids to stay hydrated, but not too much to cause fluid overload. The provider may give you a specific amount of fluid to drink per day based on your condition.
Choice D is wrong because you should not take your medication with food. Furosemide is best absorbed on an empty stomach, and food can interfere with its effectiveness. You should take furosemide at least one hour before or two hours after meals.
A nurse is caring for a client who has heart failure and is receiving captopril (Capoten). Which of the following statements by the client indicates an understanding of the medication?
Explanation
Captopril (Capoten) is an ACE inhibitor that can cause a dry, nonproductive cough as a side effect. This cough may be bothersome and interfere with the quality of life of the client.The client should inform the provider if this occurs, as the medication may need to be changed or adjusted.
Choice A is wrong because captopril should be taken one hour before meals, not with food.Food may decrease the absorption and effectiveness of the medication.
Choice B is wrong because captopril can cause hyperkalemia, or high levels of potassium in the blood, by decreasing aldosterone secretion.The client should avoid foods high in potassium, such as bananas, oranges, potatoes, and tomatoes, and have their potassium levels monitored regularly.
Choice D is wrong because captopril can cause hypotension, or low blood pressure, especially when the client first starts taking the medication or when the dose is increased.The client should take captopril in the morning or during the day, not at bedtime, to avoid orthostatic hypotension and falls.The client should also rise slowly from a sitting or lying position and report any symptoms of dizziness, lightheadedness, or fainting to the provider.
A nurse is caring for a client who has heart failure and is receiving lisinopril (Zestril). Which of the following findings should indicate to the nurse that the medication is effective?
Explanation
Choice B is wrong because Increased urine output.This indicates that the medication is effective in reducing the fluid overload and improving the renal perfusion in the client who has heart failure.
Choice A is wrong because decreased blood pressure is not a specific indicator of the medication’s effectiveness. Lisinopril (Zestril) is an angiotensin-converting enzyme (ACE) inhibitor that lowers blood pressure by blocking the conversion of angiotensin I to angiotensin II, a potent vasoconstrictor.However, blood pressure can also be affected by other factors, such as dehydration, bleeding, or shock.
Choice C is wrong because increased heart rate is not a desired outcome of the medication. Lisinopril (Zestril) does not directly affect the heart rate, but it may cause reflex tachycardia as a compensatory mechanism for the reduced blood pressure.Increased heart rate can also worsen the cardiac workload and oxygen demand in the client who has heart failure.
Choice D is wrong because decreased respiratory rate is not a reliable sign of the medication’s effectiveness.Lisinopril (Zestril) may help reduce pulmonary congestion and dyspnea in the client who has heart failure, but respiratory rate can also be influenced by other factors, such as sedation, pain, or anxiety.
Normal ranges for vital signs are as follows:
• Blood pressure: 90/60 mm Hg to 120/80 mm Hg
• Heart rate: 60 to 100 beats per minute
• Respiratory rate: 12 to 20 breaths per minute
• Urine output: at least 30 mL per hour
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