Nokea
After teaching a group of nursing students about antiarrhythmics, the instructor determines that the teaching was successful when the students identify which of the following as a class IA antiarrhythmic? Select all that apply.
- A. Quinidine (Quinaglute)
- B. Lidocaine (Xylocaine)
- C. Propafenone (Rythmol)
- D. Disopyramide (Norpace)
- E. Flecainide (Tambocor)
Correct Answer: A,D
Rationale: Class IA antiarrhythmics include disopyramide and quinidine. Lidocaine is a class IB drug. Propafenone and flecainide are class IC drugs.
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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.
A client on antiarrhythmic drug therapy complains of nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which of the following drugs should the nurse consider as the possible cause?
- A. Lidocaine
- B. Quinidine
- C. Flecainide
- D. Procainamide
Correct Answer: B
Rationale: The nurse should consider the drug quinidine as the cause for these adverse reactions. Quinidine toxicity is called cinchonism. Some of its symptoms include ringing in the ears (tinnitus), hearing loss, headache, nausea, vomiting, abdominal pain, dizziness, vertigo, and lightheadedness. Lidocaine, flecainide, and procainamide do not cause tinnitus or hearing loss.
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.
Which of the following should be included in the nurse's ongoing assessment of a client receiving flecainide (Tambocor)? Select all that apply.
- A. Response to therapy
- B. Signs of heart failure
- C. Development of new cardiac arrhythmias
- D. Worsening of arrhythmia being treated
- E. Monitoring of serum flecainide levels
Correct Answer: A,B,C,D,E
Rationale: The nurse should closely monitor the client for a response to drug therapy, signs of heart failure, the development of new arrhythmias, worsening of the arrhythmia being treated, and serum flecainide levels.
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.