Prepare for NCLEX success with today’s question: Learn which medication to administer for a client with cardiomyopathy and atrial fibrillation to prevent thrombus formation. Can you identify the correct choice?
The nurse on the medical unit is reviewing the medication administration record (MAR) of a client with cardiomyopathy and atrial fibrillation. Which medication should the nurse plan to administer to prevent thrombus formation?
A. Benazepril 10 mg PO daily
B. Warfarin 5 mg PO daily
C. Furosemide 40 mg IV daily
D. Dobutamine 100 mg in 100 mL of D5W infused intravenously at 70 mcg/min
Scroll down for the correct answer!
The correct answer to today’s NCLEX-RN® Question is…
B. Warfarin 5 mg PO daily
Rationale: Warfarin is an anticoagulant administered to prevent thrombus formation in clients with cardiomyopathy-associated dysrhythmias.
Major Takeaway
Cardiomyopathies are a group of diseases of the myocardium, which is the muscle layer of the heart wall. The three main types are dilated cardiomyopathy, which is the most common one, hypertrophic, and restrictive cardiomyopathy. The goal of treatment in cardiomyopathies is to relieve symptoms and ensure that the heart continues to function. This involves treating the associated heart failure and arrhythmias with medications like beta-blockers and angiotensin-converting enzyme (ACE) inhibitors and vasodilators, such as dobutamine and milrinone, which help decrease the heart’s workload, and diuretics to reduce fluid overload. Anticoagulants, like warfarin, can also be administered to prevent thrombus formation, especially in those who develop secondary dysrhythmias like atrial fibrillation. Additionally, clients prone to arrhythmias need an implanted pacemaker or a cardioverter-defibrillator device (ICD). Some clients also need a left ventricular assist device (LVAD), a mechanical pump that assists the heart in distributing blood. In extreme cases, a client with cardiomyopathy might require a heart transplant. Some clients may require additional treatment, which depends on the type of cardiomyopathy. So, those with hypertrophic cardiomyopathy might require procedures to reduce the wall thickness, such as alcohol septal ablation, ventriculostomy, and septal myectomy, where part of the thickened septal wall is removed.
Incorrect answer explanations
A. Benazepril 10 mg PO daily
Rationale: Angiotensin-converting enzyme (ACE) inhibitors, such as benazepril, are beneficial in reducing cardiac workload associated with heart failure rather than preventing thrombi.
C. Furosemide 40 mg IV daily
Rationale: Furosemide is a loop diuretic administered to reduce fluid overload associated with cardiomyopathy rather than prevent thrombi formation.
D. Dobutamine 100 mg in 100 mL of D5W infused intravenously at 70 mcg/min
Rationale: Dobutamine, a potent vasodilator, is beneficial in reducing cardiac workload associated with heart failure rather than preventing thrombi.
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