Nokea
A nurse is reviewing a journal article about class IA antiarrhythmics. The article describes a drug that decreases depolarization and prolongs the refractory period. The nurse is most likely reading an article about which drug?
- A. Quinidine
- B. Lidocaine
- C. Disopyramide
- D. Flecainide
Correct Answer: C
Rationale: Disopyramide (Norpace) decreases depolarization of myocardial fibers, prolongs the refractory period, and increases the action potential duration of cardiac cells. Lidocaine (Xylocaine) decreases diastolic depolarization, decreases automaticity of ventricular cells, and raises the threshold of the ventricular myocardium. Quinidine depresses myocardial excitability or the ability of the myocardium to respond to an electrical stimulus. Flecainide (Tambocor) depresses fast sodium channels, decreases the height and rate of rise of action potentials, and slows conduction of all areas of the heart.
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When describing arrhythmias to a group of nursing students, the instructor explains that arrhythmias may be triggered by which of the following? Select all that apply.
- A. Emotional stress
- B. Heart disease
- C. Electrolyte imbalance
- D. Diabetes
- E. Hypoxia
Correct Answer: A,B,C,E
Rationale: Arrhythmias may occur as a result of heart disease, a disorder that affects cardiovascular function, emotional stress, hypoxia, and electrolyte imbalances. Diabetes is not a direct trigger for arrhythmias but may contribute indirectly through cardiovascular complications.
A nurse is reading a journal article about propranolol. Which of the following would the nurse expect to find discussed? Select all that apply.
- A. Is a class III antiarrhythmic
- B. Acts by blocking beta-adrenergic receptors of the heart and kidney
- C. Reduces the release of renin
- D. Increases excitability of the heart
- E. Has membrane-stabilizing effects
Correct Answer: B,C,E
Rationale: Propranolol (Inderal) is a class II antiarrhythmic that acts by blocking beta-adrenergic receptors of the heart and kidney, reducing the influence of the sympathetic nervous system on these areas, decreasing the excitability of the heart and the release of renin. Propranolol also has membrane-stabilizing effects.
A nurse is caring for a client receiving an oral antiarrhythmic drug. Which apical pulse rate would lead the nurse to withhold the drug and notify the health care provider immediately?
- A. 58 beats/min
- B. 68 beats/min
- C. 78 beats/min
- D. 88 beats/min
Correct Answer: A
Rationale: The nurse should withhold the drug and report to the primary health care provider whenever the client's pulse rate falls below 60 beats/min or rises to more than 120 beats/min. Pulse rates of 68 beats/min, 78 beats/min, and 88 beats/min fall within the normal range.
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.
When evaluating a client who is receiving antiarrhythmic therapy, which of the following would the nurse interpret as an expected outcome? Select all that apply.
- A. No evidence of injury is seen.
- B. No evidence of infection is seen.
- C. Client is free of nausea.
- D. Client urinates adequately.
- E. Oral mucous membranes are intact and moist
Correct Answer: A,B,C,D,E
Rationale: Absence of injury, infection, and nausea, adequate renal function, and intact, moist oral mucous membranes are expected outcomes for antiarrhythmic therapy.