Nokea
The nursing student is taking a pre-nursing pharmacology class. Today, the nursing student is learning about antiarrhythmic drugs. What drug is a potassium channel blocker?
- A. Amiodarone
- B. Lidocaine
- C. Flecainide
- D. Isoproterenol
Correct Answer: A
Rationale: Potassium channel blockers include amiodarone and bretylium tosylate. Lidocaine and flecainide are sodium channel blockers. Isoproterenol is a beta-blocker.
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The client has just been admitted with bradycardia and scheduled for the insertion of a pacemaker. The nurse notifies the physician that the client's heart rate has dropped into the 40 beats/minute range. The physician orders a temporary pacemaker. The nurse knows that there are different types of temporary pacemakers. What types of temporary pacemakers are there? Select all that apply.
- A. Transatrial
- B. Transcutaneous
- C. Transvenous
- D. Transthoracic
- E. Transabdominal
Correct Answer: B,C,D
Rationale: The three types of temporary pacemakers are transcutaneous, transvenous, and transthoracic. Transatrial and transabdominal are not types of temporary pacemakers.
The nurse and student nurse are observing a cardioversion procedure. The nurse is correct to tell the student that electrical current will be initiated at which time?
- A. During stimulation of the SA node
- B. During repolarization of the heart
- C. During ventricular depolarization
- D. During the contraction phase
Correct Answer: C
Rationale: The electrical current is initiated at the R wave when ventricular depolarization occurs. The electrical current completely depolarizes the entire myocardium with the goal of restoring the normal pacemaker of the heart.
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated?
- A. The registered nurse stating to administer digoxin
- B. The registered nurse administering atropine sulfate intravenously
- C. The registered nurse stating to hold all medication until the pulse rate returns to 60 beats/minute
- D. The registered nurse stating to administer all medications except those which are cardiotonics
Correct Answer: B
Rationale: The licensed practical nurse and registered nurse both identify that client's bradycardia. Atropine sulfate, a cholinergic blocking agent, is given intravenously (IV) to increase a dangerously slow heart rate. Lanoxin is not administered when the pulse rate falls under 60 beats/minute. It is dangerous to wait until the pulse rate increases without nursing intervention or administering additional medications until the imminent concern is addressed.
The nurse is caring for a client with an arrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the arrhythmia to be which of the following?
- A. Peripheral vascular disease
- B. Ischemic heart disease
- C. Aortic stenosis
- D. Atherosclerotic heart disease
Correct Answer: B
Rationale: The nurse realizes that the most common cause of arrhythmias is ischemic heart disease. When the heart does not obtain sufficient blood to meet demands, the heart works harder to circulate body fluids and becomes inefficient in the process. Problems with the peripheral vessels, narrowing of the aorta and plaque build-up in the vessels may be a component of the disease process but not the best answer.
The nurse knows that a pacemaker is the treatment of choice for what cardiac arrhythmia?
- A. Supraventricular tachycardia
- B. Atrial flutter
- C. Ventricular fibrillation
- D. Complete heart block
Correct Answer: D
Rationale: Pacemaker insertion is the treatment for complete heart block. Treatments for supraventricular tachycardia are: Valsalva maneuver, unilateral carotid massage, immersion of face in ice water, administration of IV adenosine, cardioversion, and radiofrequency ablation. Cardioversion and drug therapy are used for the treatment of atrial flutter. Treatment for ventricular fibrillation is defibrillation preceded by or followed with epinephrine.