A patient who has been anticoagulated with warfarin (Coumadin) has been admitted for gastrointestinal bleeding. The history and physical examination indicates that the patient may have taken too much warfarin. The nurse anticipates that the patient will receive which antidote?

Correct Answer: B

Rationale: Vitamin K is the antidote for warfarin (Coumadin) toxicity. Warfarin is a vitamin K antagonist that inhibits the synthesis of vitamin K-dependent coagulation factors (II, VII, IX, X) in the liver. In cases of excessive anticoagulation and bleeding, administering vitamin K can help reverse the effects of warfarin by replenishing the depleted vitamin K-dependent clotting factors. Vitamin K helps the liver produce clotting factors, thereby promoting the clotting process and reversing the excessive anticoagulant effects of warfarin. Other options mentioned, such as Vitamin E, Protamine sulfate, and Potassium chloride, are not appropriate antidotes for warfarin toxicity.

Correct Answer: A

Rationale: The correct answer is option A) "Do not chew or crush extended-release forms of medication." This instruction is crucial for patients taking antidysrhythmic drugs because extended-release formulations are designed to release the medication slowly over time, maintaining a consistent level in the bloodstream. Chewing or crushing these forms can lead to a rapid release of the drug, potentially causing adverse effects or decreasing the drug's efficacy. Option C) "Take the medication with food if gastrointestinal distress occurs" is incorrect because antidysrhythmic drugs are typically recommended to be taken on an empty stomach to enhance absorption. Taking them with food may interfere with the drug's absorption or alter its effectiveness. Option D) "If a dose is missed, the missed dose should be taken along with the next dose that is due to be taken" is also incorrect. In the case of missed doses of antidysrhythmic drugs, patients should usually be instructed to skip the missed dose and continue with the next scheduled dose. Doubling up on doses can increase the risk of side effects or toxicity. Educationally, understanding the specific administration instructions for antidysrhythmic drugs is crucial for patient safety and optimal therapeutic outcomes. Patients need clear guidance on how to take their medications correctly to ensure effectiveness and minimize potential risks. Teaching patients about the importance of following medication instructions precisely can help prevent medication errors and improve treatment outcomes.

Correct Answer: C

Rationale: Digoxin is a medication commonly used to treat heart failure and certain types of irregular heartbeats. It works by increasing the force of contraction of the heart muscle, thereby increasing cardiac output. Additionally, digoxin also has the ability to slow down the heart rate, making it helpful in conditions such as atrial fibrillation. Heparin is an anticoagulant medication used to prevent blood clot formation, while Alprazolam is a benzodiazepine used to treat anxiety disorders. Levothyroxine is a thyroid hormone replacement medication to treat hypothyroidism. None of these drugs have the therapeutic effects of increasing cardiac output and slowing heart rate like digoxin.

Correct Answer: C

Rationale: Acetylcysteine is the specific antidote for acetaminophen overdose. Acetaminophen (also known as paracetamol) toxicity can cause severe liver damage if not treated promptly. Acetylcysteine works by replenishing the depleted glutathione stores in the liver, helping to prevent liver damage and improving the patient's outcome. Naloxone is used for opioid overdose, vitamin K for reversing the effects of certain anticoagulants, and atropine for specific heart and nerve related conditions.

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Fatigue. When a patient is taking Digoxin, a medication commonly used to treat heart conditions, monitoring and reporting fatigue is crucial as it can indicate toxicity. Fatigue can be a sign of decreased cardiac output, a potential adverse effect of Digoxin. Option B) Constipation is not typically associated with Digoxin use and is not a commonly reported adverse effect. Option C) Anorexia is also not a common adverse effect of Digoxin. Option D) Rash is not a typical adverse effect of Digoxin either. Educationally, it is important for nurses to understand the specific adverse effects associated with medications like Digoxin to ensure patient safety and effective care. Monitoring and educating patients on these adverse effects can lead to early detection and intervention, preventing potential complications. This knowledge also helps nurses in providing comprehensive patient education, promoting adherence to medication regimens, and improving patient outcomes.