Nokea
A nurse would administer disopyramide cautiously to a client with which condition? Select all that apply.
- A. Myasthenia gravis
- B. Diabetes
- C. Glaucoma
- D. Urinary retention
- E. Hypothyroidism
Correct Answer: A,C,D
Rationale: Disopyramide is used cautiously in clients with myasthenia gravis, urinary retention, or glaucoma and in men with prostate enlargement. Diabetes and hypothyroidism are not specifically contraindicated but require monitoring.
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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 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.
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.
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.
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.