Page 1772 - Saunders Comprehensive Review For NCLEX-RN

B. Side and adverse effects

1. Bruising
2. Hematuria
3. Gastrointestinal bleeding
4. Tarry stools
C. Interventions
1. A blood test may be prescribed to determine the
client’s sensitivity to the medication before beginning
administration.
2. Monitor vital signs.
3. Instruct the client to take medication with food if
gastrointestinal upset occurs.
4. Monitor bleeding time.

5. Instruct the client to monitor for side and

adverse effects and in the measures to prevent
bleeding.
IV. Positive Inotropic and Cardiotonic Medications (Box 53-5)
A. Description
1. These medications stimulate myocardial contractility
and produce a positive inotropic effect.
2. These medications are used for short-term
management of advanced heart failure; the increase in
myocardial contractility improves cardiac, peripheral,
and kidney function by increasing cardiac output,
decreasing preload, improving blood flow to the
periphery and kidneys, decreasing edema, and
increasing fluid excretion. As a result, fluid retention
in the lungs and extremities is decreased (Fig. 53-1).
B. Side and adverse effects
1. Dysrhythmias
2. Hypotension
3. Thrombocytopenia
4. Hepatotoxicity manifested by elevated liver enzyme
levels
5. Hypersensitivity manifested by wheezing, shortness of
breath, pruritus, urticaria, clammy skin, and flushing

C. Interventions

1. Positive inotropic and cardiotonic medications are
used for intravenous (IV) administration.
a. For continuous IV infusion, administer
with an infusion pump.
b. Stop the infusion if the client’s blood
pressure (BP) drops or dysrhythmias
occur.

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