Nokea
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.
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A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia?
- A. Diltiazem
- B. Verapamil
- C. Amiodarone
- D. Adenosine
Correct Answer: C
Rationale: Amiodarone is the drug of choice for ventricular dysrhythmias per Advanced Cardiac Life Support guidelines due to its effectiveness in stabilizing ventricular rhythms. Diltiazem, verapamil, and adenosine are used for other dysrhythmias.
Which patient-teaching instructions are appropriate for a patient taking an antidysrhythmic drug? (Select all that apply.)
- A. Do not chew or crush extended-release forms of medication.
- B. Take the medication with food if gastrointestinal distress occurs.
- C. If a dose is missed, the missed dose should be taken along with the next dose that is due to be taken.
- D. Take the medications with an antacid if gastrointestinal distress occurs.
- E. Limit or avoid the use of caffeine.
- F. The presence of a capsule in the stool should be reported to the physician immediately.
Correct Answer: A,B,E
Rationale: Appropriate instructions include not chewing/crushing extended-release forms, taking with food for GI distress, and limiting caffeine due to its cardiac stimulant effects. Doubling doses, using antacids, or reporting wax matrices in stool (normal for some formulations) are incorrect.
A patient is in the emergency department with a new onset of rapid-rate atrial fibrillation, and the nurse is preparing a continuous infusion. Which drug is most appropriate for this dysrhythmia?
- A. Diltiazem
- B. Atenolol
- C. Lidocaine
- D. Adenosine
Correct Answer: A
Rationale: Diltiazem is used for rate control in atrial fibrillation by slowing AV node conduction, making it appropriate for rapid-rate atrial fibrillation. Atenolol, lidocaine, and adenosine are not primarily used for this purpose.
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.
A patient has been started on therapy of a continuous infusion of lidocaine after receiving a loading dose of the drug. The nurse will monitor the patient for which adverse effect?
- A. Drowsiness
- B. Nystagmus
- C. Dry mouth
- D. Convulsions
Correct Answer: D
Rationale: Lidocaine toxicity can cause convulsions due to central nervous system effects. Drowsiness, nystagmus, and dry mouth are not primary adverse effects of lidocaine.