Nokea
A nurse assesses the results of a client's complete blood count observing for agranulocytosis for a client receiving which antiarrhythmic? Select all that apply.
- A. Verapamil (Calan)
- B. Lidocaine (Xylocaine)
- C. Sotalol (Betapace)
- D. Quinidine (Quinaglute)
- E. Mexiletine (Mexitil)
Correct Answer: A,D,E
Rationale: Agranulocytosis has been reported with the use of verapamil, quinidine, and mexiletine.
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A client with cardiac arrhythmia is prescribed ibutilide IV. The client weighs 63 kg. The nurse would expect to administer the drug over which time frame?
- A. 1 minute
- B. 5 minutes
- C. 10 minutes
- D. 30 minutes
Correct Answer: C
Rationale: Ibutilide is administered IV over 10 minutes.
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.
The nurse should monitor a client receiving lidocaine (Xylocaine) IV closely for which of the following? Select all that apply.
- A. Heartburn
- B. Apprehension
- C. Hypotension
- D. Auditory changes
- E. Bradycardia
Correct Answer: B,C,E
Rationale: The nurse must observe the client closely for signs of apprehension, hypotension, and bradycardia. Auditory changes are seen with quinidine, not lidocaine. Heartburn is associated with mexiletine.
A client has been prescribed an antiarrhythmic. Which of the following points should the nurse include in the client teaching plan?
- A. Decrease the dose if adverse effects occur.
- B. Chew the tablets well before swallowing.
- C. Take frequent sips of water or chew gum.
- D. Take the drug only on an empty stomach.
Correct Answer: C
Rationale: The nurse should instruct the client to take frequent sips of water or chew gum to avoid dryness of the mouth. The nurse should instruct the client not to stop the medication or change the dose and schedule without consulting the health care provider. The tablets should not be chewed or crushed. They should be swallowed whole. Taking the drug on an empty stomach may cause gastric upset. The drug should be taken with food.
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.