Nokea
Before administering any antiarrhythmic, the nurse would assess which of the following? Select all that apply.
- A. Skin color
- B. Blood glucose
- C. Input and output
- D. Orientation
- E. Level of consciousness
Correct Answer: A,D,E
Rationale: The preadministration assessment of the client's general condition should include observations such as skin color, orientation, level of consciousness, and the client's general status. Blood glucose and input/output are not directly relevant unless specified.
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When explaining how verapamil (Calan) produces its effects on the cardiovascular system, which of the following would the nurse integrate into the explanation? Select all that apply.
- A. Reduction in the release of renin
- B. Dilation of coronary arteries
- C. Dilation of peripheral arteries
- D. Slowed conduction through the SA and AV nodes
- E. Membrane-stabilizing effects
Correct Answer: B,C,D
Rationale: Verapamil (Calan) is a calcium channel blocker. These drugs inhibit the movement of calcium through channels across the myocardial cell membranes and vascular smooth muscle. Cardiac and vascular smooth muscle depends on the movement of calcium ions into the muscle cells through specific ion channels. When this movement is inhibited, the coronary and peripheral arteries dilate, thereby decreasing the force of cardiac contraction. This drug also reduces heart rate by slowing conduction through the SA and AV nodes.
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 client with cardiac arrhythmia is prescribed verapamil. The nurse would instruct the client about which of the following as a possible adverse reaction?
- A. Diarrhea
- B. Hyperactivity
- C. Peripheral edema
- D. Hypertension
Correct Answer: C
Rationale: The nurse should inform the client that peripheral edema could be an adverse reaction to verapamil therapy. Diarrhea, hyperactivity, and hypertension are not adverse reactions associated with verapamil therapy. Other adverse reactions associated with verapamil are constipation, mental depression, and hypotension.
Administration with which of the following would increase serum concentrations of disopyramide? Select all that apply.
- A. Amiodarone
- B. Quinidine
- C. Rifampin
- D. Cimetidine
- E. Erythromycin
Correct Answer: B,E
Rationale: Increased serum disopyramide levels occur when quinidine or erythromycin is given with disopyramide. Amiodarone and cimetidine increase serum flecainide levels. Rifampin decreases serum disopyramide 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.