Nokea
A nurse is caring for a client who is prescribed mexiletine for the treatment of a cardiac arrhythmia. Which adverse reaction would lead the nurse to identify a nursing diagnosis of Risk for Infection?
- A. Lightheadedness
- B. Dry mouth
- C. Agranulocytosis
- D. Nausea
Correct Answer: C
Rationale: A nursing diagnosis of Risk for Infection related to the adverse reaction of the drug may be made in the case of agranulocytosis. Lightheadedness would lead to a nursing diagnosis of Risk for Injury related to the adverse effect of the drug. Dry mouth leads to a nursing diagnosis of Impaired Oral Mucous Membranes related to the adverse effect of the drug. Nausea does not indicate the implementation of the nursing diagnosis of Risk for Infection.
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Which of the following should be included in the nurse's ongoing assessment of a client receiving flecainide (Tambocor)? Select all that apply.
- A. Response to therapy
- B. Signs of heart failure
- C. Development of new cardiac arrhythmias
- D. Worsening of arrhythmia being treated
- E. Monitoring of serum flecainide levels
Correct Answer: A,B,C,D,E
Rationale: The nurse should closely monitor the client for a response to drug therapy, signs of heart failure, the development of new arrhythmias, worsening of the arrhythmia being treated, and serum flecainide levels.
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 identifies a nursing diagnosis of Nausea secondary to the effects of antiarrhythmic therapy. Which of the following would the nurse include in the client's plan of care? Select all that apply.
- A. Administering the drug with food
- B. Having the client lie flat for 2 hours after eating
- C. Scanning the client's bladder for distention
- D. Offering small, frequent meals
- E. Encouraging gradual position changes
Correct Answer: A,D
Rationale: To combat nausea, the nurse would administer the drug with food and offer the client small, frequent meals. The nurse would encourage the client to keep his head at least 4 inches higher than his feet when resting or reclining. Scanning for bladder distention would be appropriate if the client experienced urinary retention. Encouraging gradual position changes would be appropriate for the client at risk for injury from dizziness or lightheadedness.
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.
Quinidine is prescribed to a client with cardiac arrhythmia. When documenting the client's drug history, the nurse inquires about the concomitant use of any other drug. Which of the following drugs when given concomitantly may cause an increase in serum quinidine levels?
- A. Cimetidine
- B. Rifampin
- C. Hydantoins
- D. Nifedipine
Correct Answer: A
Rationale: Cimetidine, when given concurrently with quinidine, may cause an increase in serum quinidine levels. Hydantoins and nifedipine cause a decrease in serum quinidine levels. Rifampin does not interact with quinidine.