Nokea
When educating a group of nursing students on the mechanism of action of various antiarrhythmic drugs, the nurse identifies which of the following drugs as inhibiting the beta-adrenergic receptors of the heart and kidney?
- A. Propafenone
- B. Amiodarone
- C. Disopyramide
- D. Acebutolol
Correct Answer: D
Rationale: The nurse should inform the nursing students that acebutolol acts by inhibiting the beta-adrenergic receptors of the heart and kidney. Propafenone and amiodarone appear to act directly on the cardiac cell membrane, and not on the beta-adrenergic receptors of the heart and kidney. Disopyramide acts by decreasing the depolarization of the myocardial fibers, and not the beta-adrenergic receptors of the heart and kidney.
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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.
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.
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.
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 nurse is reading a journal article about propranolol. Which of the following would the nurse expect to find discussed? Select all that apply.
- A. Is a class III antiarrhythmic
- B. Acts by blocking beta-adrenergic receptors of the heart and kidney
- C. Reduces the release of renin
- D. Increases excitability of the heart
- E. Has membrane-stabilizing effects
Correct Answer: B,C,E
Rationale: Propranolol (Inderal) is a class II antiarrhythmic that acts by blocking beta-adrenergic receptors of the heart and kidney, reducing the influence of the sympathetic nervous system on these areas, decreasing the excitability of the heart and the release of renin. Propranolol also has membrane-stabilizing effects.