Nokea
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.
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Which of the following is important for the nurse to remember when administering quinidine (Quinaglute) orally? Select all that apply.
- A. Quinidine can be administered with food to decrease GI upset.
- B. Quinidine can cause auditory adverse reactions.
- C. Quinidine can be crushed or chewed.
- D. Normal quinidine levels are between 7 and 10 mcg/mL.
- E. Quinidine levels must be monitored during therapy.
Correct Answer: A,B,E
Rationale: Quinidine can be administered with food to decrease GI upset and can cause ringing in the ears and hearing loss. Levels should be monitored during therapy to reduce the risk of quinidine toxicity. Quinidine should not be crushed or chewed, and normal quinidine levels are less than 6 mcg/mL.
A nurse is preparing to administer an antiarrhythmic and identifies the drug as a class III potassium channel blocker. Which drug would the nurse be most likely to administer?
- A. Amiodarone
- B. Flecainide
- C. Mexiletine
- D. Propafenone
Correct Answer: A
Rationale: Amiodarone is a class III potassium channel blocker. Flecainide, mexiletine, and propafenone are class I sodium channel blockers.
When educating a group of nursing students on the mechanism of action of various antiarrhythmic drugs, the nurse identifies which of the following drugs as inhibiting the beta-adrenergic receptors of the heart and kidney?
- A. Propafenone
- B. Amiodarone
- C. Disopyramide
- D. Acebutolol
Correct Answer: D
Rationale: The nurse should inform the nursing students that acebutolol acts by inhibiting the beta-adrenergic receptors of the heart and kidney. Propafenone and amiodarone appear to act directly on the cardiac cell membrane, and not on the beta-adrenergic receptors of the heart and kidney. Disopyramide acts by decreasing the depolarization of the myocardial fibers, and not the beta-adrenergic receptors of the heart and kidney.
When discussing class IB antiarrhythmics, which of the following would the nurse identify as an effect? Select all that apply.
- A. Shortening of the action potential duration
- B. Depression of cardiac conduction
- C. Prolongation of the action potential
- D. Slowing of repolarization
- E. Increase in cardiac conduction
Correct Answer: A,B
Rationale: Class IB antiarrhythmics shorten the action potential and selectively depress cardiac conduction.
Before administering any antiarrhythmic, the nurse would assess which of the following? Select all that apply.
- A. Skin color
- B. Blood glucose
- C. Input and output
- D. Orientation
- E. Level of consciousness
Correct Answer: A,D,E
Rationale: The preadministration assessment of the client's general condition should include observations such as skin color, orientation, level of consciousness, and the client's general status. Blood glucose and input/output are not directly relevant unless specified.