A patient with a history of HF presents to the emergency department with difficulty breathing, cough, and edema of the lower extremities. The nurse anticipates administration of which type of medication?

Correct Answer: C

Rationale: In the scenario described, the patient with a history of heart failure (HF) is presenting with symptoms of difficulty breathing, cough, and edema of the lower extremities. These signs and symptoms suggest acute decompensated heart failure (ADHF), which is characterized by a decrease in cardiac output and inadequate tissue perfusion. In this situation, the nurse would anticipate the administration of a positive inotrope medication.

Correct Answer: A

Rationale: Metformin belongs to the class of medications known as biguanides. Biguanides work primarily by decreasing glucose production in the liver and increasing insulin sensitivity in peripheral tissues, such as muscles. They also help improve glucose uptake and utilization by cells, leading to better control of blood sugar levels. Metformin is commonly used to treat type 2 diabetes mellitus and can also be used in the management of polycystic ovary syndrome (PCOS).

Correct Answer: C

Rationale: Penicillin is a type of antibiotic that works by disrupting the synthesis of the bacterial cell wall. Bacterial cells have a cell wall that provides structural support and protection. The cell wall is composed of peptidoglycan, a complex molecule that gives the cell wall its strength. Penicillin interferes with the formation of peptidoglycan by inhibiting the enzyme transpeptidase, which is essential for cross-linking the peptidoglycan strands. As a result, bacterial cells become more susceptible to osmotic pressure and eventually burst, leading to their death. This mechanism of action is particularly effective against rapidly growing bacterial cells because they are actively synthesizing new cell wall components to keep up with their growth. Thus, penicillin's primary effectiveness against rapidly growing cells is primarily due to its disruption of cell wall synthesis.

Correct Answer: C

Rationale: One life-threatening side effect of lithium therapy is the risk of seizures. While seizures are a rare side effect, they can occur, especially at higher doses or in patients with a history of seizure disorders. It is important to monitor for any signs of seizures in patients taking lithium and to promptly address any potential neurological symptoms.

Correct Answer: C

Rationale: The appropriate nursing diagnosis for a patient receiving antidysrhythmics would be Deficient fluid volume. Antidysrhythmics can have side effects such as electrolyte imbalances, which can lead to fluid volume deficit. Monitoring the patient's fluid intake and output is crucial to prevent dehydration and maintain proper electrolyte balance. Therefore, identifying Deficient fluid volume as a nursing diagnosis allows for appropriate interventions to be implemented to address and prevent this potential complication.

Correct Answer: A

Rationale: Metformin belongs to the class of medications known as biguanides. Biguanides work by decreasing glucose production in the liver and also improving insulin sensitivity in the muscles, helping to lower blood sugar levels in patients with type 2 diabetes. Additionally, metformin can also reduce glucose absorption in the intestines and increase glucose uptake in peripheral tissues. Its main pharmacological action is to improve glycemic control and reduce hyperglycemia in patients with diabetes.

Correct Answer: C

Rationale: The most common side effect that is normal with the initial therapy of Nitroglycerine due to increased vasodilation is a headache. Nitroglycerine causes vasodilation of blood vessels, including the blood vessels in the head and brain. This can lead to headaches as a result of the increased blood flow and changes in blood vessel diameter. Headaches caused by Nitroglycerine are usually mild and transient. It is important to monitor patients for this expected side effect and educate them about it to ensure compliance with the medication regimen.

Correct Answer: B

Rationale: Ibutilide (Corvert) is a medication commonly used to treat atrial fibrillation, a type of irregular heart rhythm that originates in the heart's upper chambers (atria). It works by restoring normal heart rhythm in patients with atrial fibrillation. Therefore, the nurse notes the use of ibutilide in the patient's medication orders, indicating that the patient has atrial fibrillation.

Correct Answer: C

Rationale: Celecoxib is a selective COX-2 inhibitor, which means it primarily targets the COX-2 enzyme involved in inflammation and pain while sparing the COX-1 enzyme that protects the stomach lining. This selectivity reduces the risk of gastrointestinal distress, such as ulcers and bleeding, compared to non-selective NSAIDs like aspirin, ketorolac, and ibuprofen. Therefore, celecoxib is the best choice for patients who require a nonopioid medication with minimal gastrointestinal side effects. Nurses should consider this when selecting pain management options for patients with a history of gastrointestinal issues.