Nokea
A patient is taking quinidine for the treatment of dysrhythmias. The nurse will monitor for which adverse effect of this drug?
- A. Diarrhea
- B. Tachycardia
- C. Tinnitus
- D. Dry mouth
Correct Answer: C
Rationale: Quinidine, a class Ia antidysrhythmic, can cause cinchonism, characterized by tinnitus, hearing loss, and gastrointestinal upset. Diarrhea, tachycardia, and dry mouth are not primary adverse effects.
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The nurse is preparing to administer a bolus dose of verapamil as follows: 'Give 5-mg bolus of verapamil, IV push, over 2 minutes. May repeat in 30 minutes if needed.' The medication is available in a 2.5-mg/mL strength solution. Identify how many milliliters will the nurse draw into the syringe for this dose.
Correct Answer: 2 mL
Rationale: To calculate: 2.5 mg/1 mL = 5 mg/x mL. Cross-multiply: (2.5 * x) = (1 * 5); 2.5x = 5; x = 5/2.5 = 2 mL.
A 62-year-old man is to receive lidocaine as treatment for a symptomatic dysrhythmia. Upon assessment, the nurse notes that he has a history of alcoholism and has late-stage liver failure. The nurse will expect which adjustments to his drug therapy?
- A. The dosage will be reduced by 50%.
- B. A diuretic will be added to the lidocaine.
- C. The lidocaine will be changed to an oral dosage form.
- D. An increased dosage of lidocaine will be prescribed so as to obtain adequate blood levels.
Correct Answer: A
Rationale: Lidocaine is metabolized by the liver, so in liver failure, a 50% dosage reduction is often necessary to prevent toxicity. Lidocaine is not given orally, diuretics are not added, and increasing the dose is unsafe.
A patient is taking procainamide for a cardiac dysrhythmia. The nurse will monitor the patient for which possible adverse effect?
- A. Bradycardia
- B. Shortened QT interval
- C. Dyspnea
- D. Diarrhea
Correct Answer: D
Rationale: Procainamide, a class Ia antidysrhythmic, can cause gastrointestinal side effects like diarrhea. Bradycardia, shortened QT interval, and dyspnea are not commonly associated with procainamide.
When starting a patient on antidysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?
- A. Deficiency of fat-soluble vitamins
- B. Hyperkalemia
- C. Heart failure
- D. Dysrhythmias
Correct Answer: D
Rationale: Antidysrhythmic drugs can cause new dysrhythmias (prodysrhythmic effect) due to their effects on cardiac electrophysiology. Fat-soluble vitamin deficiency, hyperkalemia, and heart failure are not universal adverse effects.
The nurse is preparing to administer adenosine to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving this medication, which is important to remember?
- A. The onset of action occurs within 5 minutes.
- B. The medication must be given as a slow intravenous (IV) push.
- C. Asystole may occur for a few seconds after administration.
- D. The medication has a long half-life, and therefore duration of action is very long.
Correct Answer: C
Rationale: Adenosine has a very short half-life (<10 seconds) and is given as a rapid IV push. A brief period of asystole may occur, which is expected due to its transient AV node blockade. Slow IV push or long half-life are incorrect.