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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.
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The nurse should monitor a client receiving lidocaine (Xylocaine) IV closely for which of the following? Select all that apply.
- A. Heartburn
- B. Apprehension
- C. Hypotension
- D. Auditory changes
- E. Bradycardia
Correct Answer: B,C,E
Rationale: The nurse must observe the client closely for signs of apprehension, hypotension, and bradycardia. Auditory changes are seen with quinidine, not lidocaine. Heartburn is associated with mexiletine.
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.
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.
A client receiving antiarrhythmic therapy develops a new arrhythmia due to the administration of the drug. The nurse documents this as which of the following?
- A. Cinchonism
- B. Refractory period
- C. Proarrhythmic effect
- D. Action potential
Correct Answer: C
Rationale: The development of a new arrhythmia due to drug administration is referred to as a proarrhythmic effect. Cinchonism refers to quinidine toxicity. Refractory period refers to the quiet period between the transmission of nerve impulses along a nerve fiber. Action potential refers to the electrical impulse that passes from cell to cell in the myocardium of the heart and stimulates the fibers to shorten, causing heart muscles to contract.