Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?

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: 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.

Correct Answer: C

Rationale: Milrinone (Primacor) is a phosphodiesterase inhibitor that acts by increasing the levels of cyclic adenosine monophosphate (cAMP) in cardiac muscle cells. This leads to an increased force of cardiac contractions, which is known as a positive inotropic effect. This effect results in the heart muscle contracting more forcefully, leading to an increased cardiac output. The other options (A. Increased heart rate, B. Increased blood vessel dilation, D. Increased conduction of electrical impulses across the heart) do not directly relate to the inotropic effect of milrinone.

Correct Answer: A

Rationale: The nurse will know that it is important to teach the patient to take extra precautions when standing up because of the potential risk of orthostatic hypotension and falls while taking a diuretic for hypertension. Orthostatic hypotension is a common side effect of diuretics, which can lead to dizziness or lightheadedness when changing positions, particularly when standing up quickly. This can increase the risk of falls and injury, especially in elderly patients like this 79-year-old individual. Therefore, the teaching point about taking extra precautions while standing up is crucial for the safety and well-being of the patient.