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: A patient with a history of heart failure (HF) presenting with difficulty breathing, cough, and lower extremity edema is likely experiencing decompensated HF, which is characterized by a decrease in cardiac output and inadequate tissue perfusion. Positive inotropes are medications that increase cardiac contractility, helping to improve the heart's pumping ability. By administering a positive inotrope, such as dobutamine or milrinone, the nurse can help enhance the heart's contractility, increase cardiac output, and improve overall tissue perfusion in the patient with decompensated HF. This can help alleviate symptoms such as difficulty breathing and edema in the lower extremities.

Correct Answer: C

Rationale: When a patient is receiving antidysrhythmics, there is a risk of fluid and electrolyte disturbances due to the medication's effects on the heart's electrical activity. Antidysrhythmics can cause arrhythmias, which can impact cardiac output and blood pressure, potentially leading to fluid volume deficits. It is essential for nurses to monitor the patient's fluid balance closely and address any deficits promptly to prevent complications. Therefore, the nursing diagnosis of Deficient fluid volume is most appropriate for a patient receiving antidysrhythmics.

Correct Answer: D

Rationale: The nurse's priority action would be to discontinue the infusion immediately and notify the prescriber. The patient developing chills and back pain during a blood transfusion may be signs of a transfusion reaction, possibly indicating an incompatibility or adverse reaction to the blood product. It is crucial to stop the transfusion to prevent further complications and to notify the prescriber immediately so that appropriate interventions can be initiated promptly. Observing for other symptoms and slowing the infusion rate are secondary actions compared to discontinuing the infusion and informing the prescriber in this situation. Telling the patient that these symptoms are a normal reaction to the blood product is incorrect as the symptoms could indicate a serious issue that needs to be addressed promptly.

Correct Answer: C

Rationale: The response, "This drug is the first medication your health care provider will use to treat your angina," is accurate because Ranexa (ranolazine) is commonly used as a first-line treatment for chronic angina. It is typically prescribed when other angina medications, such as beta-blockers or calcium channel blockers, are not sufficient or well-tolerated by the patient. Ranexa works by helping the heart muscle to relax, which can improve blood flow to the heart and reduce angina symptoms. It is important for the patient to understand that Ranexa is specifically intended to treat angina and should not be used for other conditions without consulting their healthcare provider.

Correct Answer: D

Rationale: The most concerning adverse effect for an older adult patient taking a vasodilator for hypertension is hypotension, which refers to abnormally low blood pressure levels. Older adults are more susceptible to experiencing drops in blood pressure due to age-related changes in their cardiovascular system. Vasodilators work by dilating blood vessels, which can further lower blood pressure. Excessive hypotension can lead to symptoms such as dizziness, lightheadedness, weakness, and falls, which can be particularly dangerous for older adults who are at a higher risk of injury. Close monitoring of blood pressure and gradual dosage titration are essential in older adult patients to minimize the risk of hypotension.