Nokea
A healthcare professional is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When assessing the client, the healthcare professional should recognize that which of the following findings is a contraindication to the administration of diltiazem?
- A. Hypotension
- B. Tachycardia
- C. Decreased level of consciousness
- D. History of diuretic use
Correct Answer: A
Rationale: Diltiazem, a calcium channel blocker, can cause hypotension. Administering it to a client who already has hypotension could exacerbate this condition. Therefore, hypotension is a contraindication to the administration of diltiazem.
Incorrect Choices:
B) Tachycardia is not a contraindication for administering diltiazem in atrial fibrillation as it is commonly used to control the heart rate.
C) Decreased level of consciousness may require evaluation but is not a direct contraindication to diltiazem administration.
D) History of diuretic use is not a contraindication if the client is not currently experiencing hypotension.
You may also like to solve these questions
A nurse is preparing to administer heparin 8,000 units subcutaneously every eight hours. The amount available is heparin injection 10,000 units/mL. How many milliliters should the nurse administer per dose? (Round the answer to the nearest tenth)
- A. 0.8 mL
- B. 0.9 mL
- C. 10.0 mL
- D. 98.0 mL
Correct Answer: A
Rationale: To determine the volume of heparin to administer per dose, divide the prescribed dose (8,000 units) by the concentration of heparin available (10,000 units/mL). 8000 units / 10000 units/mL = 0.8 mL. Therefore, the nurse should administer 0.8 mL per dose. Choice B, 0.9 mL, is incorrect as the correct calculation results in 0.8 mL. Choices C and D are significantly higher and incorrect, indicating an inaccurate calculation.
A nurse is providing teaching to a group of new parents about medications. The nurse should include that aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?
- A. Reye's syndrome
- B. Visual disturbances
- C. Diabetes mellitus
- D. Wilms' tumor
Correct Answer: A
Rationale: The correct answer is A: Reye's syndrome. Aspirin use in children with viral infections has been associated with Reye's syndrome, a serious condition that causes swelling in the liver and brain. Visual disturbances (choice B) are not typically associated with aspirin use in children with viral infections. Diabetes mellitus (choice C) and Wilms' tumor (choice D) are not adverse effects of aspirin use in this context.
A client with a severe urinary tract infection (UTI) asks why both ciprofloxacin and phenazopyridine are needed. Which of the following responses should the nurse make?
- A. Phenazopyridine decreases adverse effects of ciprofloxacin.
- B. Combining phenazopyridine with ciprofloxacin shortens the course of therapy.
- C. The use of phenazopyridine allows for a lower dosage of ciprofloxacin.
- D. Ciprofloxacin treats the infection, and phenazopyridine treats pain.
Correct Answer: D
Rationale: Ciprofloxacin is an antibiotic that treats the infection, while phenazopyridine is a urinary analgesic that relieves pain. Choice A is incorrect because phenazopyridine does not decrease adverse effects of ciprofloxacin; it primarily addresses pain. Choice B is incorrect because combining phenazopyridine with ciprofloxacin does not shorten the course of therapy; they serve different purposes. Choice C is incorrect because the use of phenazopyridine does not allow for a lower dosage of ciprofloxacin; they have independent roles in UTI management.
A client with congestive heart failure taking digoxin reports nausea and refuses to eat breakfast. Which action should the nurse take first?
- A. Encourage the client to eat the toast on the breakfast tray.
- B. Administer an antiemetic.
- C. Inform the client's provider.
- D. Check the client's apical pulse.
Correct Answer: D
Rationale: The correct action for the nurse to take first is to check the client's apical pulse. Nausea can be a sign of digoxin toxicity, and one of the early signs of digoxin toxicity is changes in the pulse rate. By checking the client's apical pulse, the nurse can assess if the digoxin level is too high. Encouraging the client to eat or administering an antiemetic may not address the underlying issue of digoxin toxicity. While informing the provider is important, assessing the client's condition through checking the apical pulse should be the immediate priority.
A nurse is planning to administer chlorothiazide 20 mg/kg/day PO divided equally and administered twice daily for a toddler who weighs 28.6 lb. The amount available is chlorothiazide oral suspension 250 mg/5 mL. How many mL should the nurse administer per dose? (Round to the nearest tenth)
- A. 2.6 mL
- B. 2.63 mL
- C. 2.7 mL
- D. 2.2 mL
Correct Answer: A
Rationale: To find the dose per administration, first convert the toddler's weight to kg: 28.6 lb · 2.2 = 13 kg. Then calculate the total daily dose: 20 mg/kg 13 kg = 260 mg/day. Since it is divided into two doses, each dose is 130 mg. The concentration of the oral suspension is 250 mg/5 mL = 50 mg/mL. Therefore, to find the volume needed per dose, divide the dose by the concentration: 130 mg · 50 mg/mL = 2.6 mL per dose. Hence, the nurse should administer 2.6 mL per dose. Choices B, C, and D are incorrect as they do not accurately calculate the dosage of chlorothiazide needed per dose based on the toddler's weight and the concentration of the oral suspension.