The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. The nurse knows that the factor that most influences the decision about which route to use is the patient's

Correct Answer: D

Rationale: In patients with heart failure, diminished circulation is a significant concern. The intravenous (IV) route is preferred over the intramuscular (IM) route because it ensures rapid and reliable drug delivery, especially in patients with compromised cardiac output. IM injections rely on adequate blood flow for absorption, which may be impaired in heart failure due to poor circulation. Altered biliary function, increased glomerular filtration, and reduced liver metabolism are less relevant to the choice of administration route in this context. Therefore, diminished circulation is the primary factor influencing the decision to use the IV route.

Correct Answer: B

Rationale: The common side effects of amitriptyline (Elavil) include constipation and dry mouth. Increasing fluid intake can help alleviate these symptoms. Adequate hydration can aid in promoting bowel regularity and relieving dry mouth. It is important for the nurse to give the patient instructions to increase their fluid intake to manage these side effects rather than immediately discontinuing the medication or requesting a change in antidepressants. If the constipation and dry mouth persist or worsen despite increasing fluid intake, then the provider may need to be notified for further evaluation and management.

Correct Answer: C

Rationale: Efficacy refers to the maximal response a drug can produce, regardless of the dose. It is a measure of how well a drug can produce its desired effect. Potency, on the other hand, refers to the amount of drug required to produce a specific effect and is not related to the maximal response. An agonist is a drug that binds to and activates a receptor. Bioavailability is the fraction of the administered dose of a drug that reaches the systemic circulation.

Correct Answer: B

Rationale: Furosemide (Lasix) belongs to the sulfonamide drug class. Patients with allergies to sulfonamides may experience cross-reactivity and have an increased risk of allergic reactions to furosemide. Therefore, it is essential for the nurse to assess the patient for any allergies to sulfonamides before administering furosemide to prevent potential adverse reactions.

Correct Answer: C

Rationale: Phenytoin exhibits non-linear kinetics because its elimination pathways become saturated at therapeutic doses, leading to a disproportionate rise in plasma levels with dose increases.