{"id":139098,"date":"2024-09-16T17:27:36","date_gmt":"2024-09-16T17:27:36","guid":{"rendered":"https:\/\/learnexams.com\/blog\/?p=139098"},"modified":"2024-09-16T17:27:38","modified_gmt":"2024-09-16T17:27:38","slug":"after-receiving-change-of-shift-report-on-a-heart-failure-unit","status":"publish","type":"post","link":"https:\/\/www.learnexams.com\/blog\/2024\/09\/16\/after-receiving-change-of-shift-report-on-a-heart-failure-unit\/","title":{"rendered":"After receiving change-of-shift report on a heart failure unit"},"content":{"rendered":"\n

After receiving change-of-shift report on a heart failure unit, which client should the nurse assess first?<\/p>\n\n\n\n

A.
Client who is taking digoxin and has a potassium level of 3.1 mEq\/L<\/p>\n\n\n\n

B.
Client who is taking captopril and has a frequent nonproductive cough<\/p>\n\n\n\n

C.
Client who is taking carvedilol (Coreg) and has a heart rate of 58<\/p>\n\n\n\n

D.
Client who is taking isosorbide dinitrate\/hydralazine (BiDil) and has a headache<\/p>\n\n\n\n

The correct answer and Explanation is :<\/strong><\/mark><\/p>\n\n\n\n

The nurse should assess Client A<\/strong> first: the client who is taking digoxin and has a potassium level of 3.1 mEq\/L.<\/p>\n\n\n\n

Explanation:<\/strong><\/p>\n\n\n\n

Digoxin is a cardiac glycoside used to manage heart failure and certain arrhythmias. It enhances the force of cardiac contraction and helps regulate heart rhythm. However, its therapeutic index is narrow, meaning that the difference between a therapeutic dose and a toxic dose is small. The effectiveness and safety of digoxin are significantly influenced by electrolyte levels, particularly potassium.<\/p>\n\n\n\n

A potassium level of 3.1 mEq\/L indicates hypokalemia (low potassium). Low potassium levels can increase the risk of digoxin toxicity, as potassium and digoxin both affect cardiac muscle contraction. Hypokalemia can exacerbate the effects of digoxin, potentially leading to serious arrhythmias or other toxic effects.<\/p>\n\n\n\n

For this reason, a client with hypokalemia who is taking digoxin requires immediate assessment and intervention to prevent potential complications. The nurse should:<\/p>\n\n\n\n

    \n
  1. Assess for Symptoms of Digoxin Toxicity:<\/strong> Symptoms may include nausea, vomiting, visual disturbances (e.g., blurred vision, yellow-green halos), confusion, or irregular heartbeats.<\/li>\n\n\n\n
  2. Monitor Cardiac Status:<\/strong> Continuous cardiac monitoring may be necessary to detect any arrhythmias.<\/li>\n\n\n\n
  3. Address the Potassium Deficiency:<\/strong> Potassium supplementation or dietary adjustments may be needed to normalize potassium levels and reduce the risk of toxicity.<\/li>\n<\/ol>\n\n\n\n

    Rationale for Not Prioritizing the Other Clients:<\/strong><\/p>\n\n\n\n

      \n
    • Client B (Captopril and nonproductive cough):<\/strong> A cough is a common side effect of ACE inhibitors like captopril, but it’s generally less urgent than the potential for digoxin toxicity.<\/li>\n\n\n\n
    • Client C (Carvedilol and heart rate of 58):<\/strong> A heart rate of 58 bpm is bradycardia and may require assessment, but it is less immediately critical compared to the risk of digoxin toxicity.<\/li>\n\n\n\n
    • Client D (Isosorbide dinitrate\/hydralazine and headache):<\/strong> While a headache can be a side effect, it’s typically less urgent than the risk of serious complications from hypokalemia and digoxin interaction.<\/li>\n<\/ul>\n\n\n\n

      Overall, addressing the hypokalemia in the client on digoxin is crucial to prevent potentially severe adverse effects and maintain safe and effective heart failure management.<\/p>\n","protected":false},"excerpt":{"rendered":"

      After receiving change-of-shift report on a heart failure unit, which client should the nurse assess first? A.Client who is taking digoxin and has a potassium level of 3.1 mEq\/L B.Client who is taking captopril and has a frequent nonproductive cough C.Client who is taking carvedilol (Coreg) and has a heart rate of 58 D.Client who […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"categories":[25],"tags":[],"class_list":["post-139098","post","type-post","status-publish","format-standard","hentry","category-exams-certification"],"_links":{"self":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/139098","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/comments?post=139098"}],"version-history":[{"count":0,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/posts\/139098\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/media?parent=139098"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/categories?post=139098"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.learnexams.com\/blog\/wp-json\/wp\/v2\/tags?post=139098"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}