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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.
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A client admitted to a health care facility with cardiac arrhythmia is prescribed propranolol. Which of the following would the nurse closely monitor as part of the ongoing assessment during the therapy?
- A. Pulse rate
- B. Tendon reflexes
- C. Hydration
- D. Visual acuity
Correct Answer: A
Rationale: During antiarrhythmic drug therapy, the nurse should closely monitor the client's pulse rate. A change in the pulse rate and rhythm will help the nurse assess a response to drug therapy, the development of signs of heart failure, the development of a new cardiac arrhythmia, or worsening of the arrhythmia being treated. It is not necessary to monitor the tendon reflexes, hydration, or visual acuity when administering an antiarrhythmic drug to the client.
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 discussing class IB antiarrhythmics, which of the following would the nurse identify as an effect? Select all that apply.
- A. Shortening of the action potential duration
- B. Depression of cardiac conduction
- C. Prolongation of the action potential
- D. Slowing of repolarization
- E. Increase in cardiac conduction
Correct Answer: A,B
Rationale: Class IB antiarrhythmics shorten the action potential and selectively depress cardiac conduction.
When educating a group of nursing students on the mechanism of action of various antiarrhythmic drugs, the nurse identifies which of the following drugs as inhibiting the beta-adrenergic receptors of the heart and kidney?
- A. Propafenone
- B. Amiodarone
- C. Disopyramide
- D. Acebutolol
Correct Answer: D
Rationale: The nurse should inform the nursing students that acebutolol acts by inhibiting the beta-adrenergic receptors of the heart and kidney. Propafenone and amiodarone appear to act directly on the cardiac cell membrane, and not on the beta-adrenergic receptors of the heart and kidney. Disopyramide acts by decreasing the depolarization of the myocardial fibers, and not the beta-adrenergic receptors of the heart and kidney.
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.