Nokea
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.
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After administering an antiarrhythmic drug, the nurse would report which of the following electrocardiogram (ECG) changes to the physician? Select all that apply.
- A. Tachycardia
- B. Prolongation of PR interval
- C. Prolongation of QT interval
- D. Widening of the QRS complex
- E. Bradycardia
Correct Answer: A,B,C,D,E
Rationale: The nurse reports to the physician any abnormalities or significant interval changes of the ECG, including tachycardia, prolongation of the PR interval or QT interval, widening of the QRS complex, or bradycardia.
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 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.
A client is admitted to the cardiology unit of a health care facility for ventricular arrhythmia. In which of the following conditions can an antiarrhythmic drug be safely administered?
- A. Aortic stenosis
- B. Premature ventricular contraction
- C. Third-degree heart block
- D. Severe heart failure
Correct Answer: B
Rationale: The nurse can safely administer an antiarrhythmic drug if the client has premature ventricular contractions. Aortic stenosis, third-degree heart block, and severe congestive heart failure are contraindications for the use of antiarrhythmic drugs.
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.