Nokea
A client receiving antiarrhythmic therapy develops a new arrhythmia due to the administration of the drug. The nurse documents this as which of the following?
- A. Cinchonism
- B. Refractory period
- C. Proarrhythmic effect
- D. Action potential
Correct Answer: C
Rationale: The development of a new arrhythmia due to drug administration is referred to as a proarrhythmic effect. Cinchonism refers to quinidine toxicity. Refractory period refers to the quiet period between the transmission of nerve impulses along a nerve fiber. Action potential refers to the electrical impulse that passes from cell to cell in the myocardium of the heart and stimulates the fibers to shorten, causing heart muscles to contract.
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A nurse is reading a journal article about propranolol. Which of the following would the nurse expect to find discussed? Select all that apply.
- A. Is a class III antiarrhythmic
- B. Acts by blocking beta-adrenergic receptors of the heart and kidney
- C. Reduces the release of renin
- D. Increases excitability of the heart
- E. Has membrane-stabilizing effects
Correct Answer: B,C,E
Rationale: Propranolol (Inderal) is a class II antiarrhythmic that acts by blocking beta-adrenergic receptors of the heart and kidney, reducing the influence of the sympathetic nervous system on these areas, decreasing the excitability of the heart and the release of renin. Propranolol also has membrane-stabilizing effects.
Administration with which of the following would increase serum concentrations of disopyramide? Select all that apply.
- A. Amiodarone
- B. Quinidine
- C. Rifampin
- D. Cimetidine
- E. Erythromycin
Correct Answer: B,E
Rationale: Increased serum disopyramide levels occur when quinidine or erythromycin is given with disopyramide. Amiodarone and cimetidine increase serum flecainide levels. Rifampin decreases serum disopyramide levels.
A client on antiarrhythmic drug therapy complains of nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which of the following drugs should the nurse consider as the possible cause?
- A. Lidocaine
- B. Quinidine
- C. Flecainide
- D. Procainamide
Correct Answer: B
Rationale: The nurse should consider the drug quinidine as the cause for these adverse reactions. Quinidine toxicity is called cinchonism. Some of its symptoms include ringing in the ears (tinnitus), hearing loss, headache, nausea, vomiting, abdominal pain, dizziness, vertigo, and lightheadedness. Lidocaine, flecainide, and procainamide do not cause tinnitus or hearing loss.
A client is diagnosed with an arrhythmia that involves irregular and rapid atrial contraction and an irregular and inefficient ventricular contraction. The nurse interprets this arrhythmia as which of the following?
- A. Atrial flutter
- B. Atrial fibrillation
- C. Ventricular tachycardia
- D. Ventricular fibrillation
Correct Answer: B
Rationale: Atrial fibrillation is characterized by irregular and rapid atrial contraction, resulting in a quivering of the atria and causing an irregular and inefficient ventricular contraction. Atrial flutter is the rapid contraction of the atria at a rate too rapid for the ventricle to pump efficiently. Ventricular tachycardia is a rapid heartbeat with a rate greater than 100 bpm. Ventricular fibrillation is rapid, disorganized contractions of the ventricles, resulting in the inability of the heart to pump any blood to the body.
A client with cardiac arrhythmia is prescribed verapamil. The nurse would instruct the client about which of the following as a possible adverse reaction?
- A. Diarrhea
- B. Hyperactivity
- C. Peripheral edema
- D. Hypertension
Correct Answer: C
Rationale: The nurse should inform the client that peripheral edema could be an adverse reaction to verapamil therapy. Diarrhea, hyperactivity, and hypertension are not adverse reactions associated with verapamil therapy. Other adverse reactions associated with verapamil are constipation, mental depression, and hypotension.