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When evaluating a client who is receiving antiarrhythmic therapy, which of the following would the nurse interpret as an expected outcome? Select all that apply.
- A. No evidence of injury is seen.
- B. No evidence of infection is seen.
- C. Client is free of nausea.
- D. Client urinates adequately.
- E. Oral mucous membranes are intact and moist
Correct Answer: A,B,C,D,E
Rationale: Absence of injury, infection, and nausea, adequate renal function, and intact, moist oral mucous membranes are expected outcomes for antiarrhythmic therapy.
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After teaching a group of nursing students about antiarrhythmics, the instructor determines that the teaching was successful when the students identify which of the following as a class IA antiarrhythmic? Select all that apply.
- A. Quinidine (Quinaglute)
- B. Lidocaine (Xylocaine)
- C. Propafenone (Rythmol)
- D. Disopyramide (Norpace)
- E. Flecainide (Tambocor)
Correct Answer: A,D
Rationale: Class IA antiarrhythmics include disopyramide and quinidine. Lidocaine is a class IB drug. Propafenone and flecainide are class IC drugs.
A client is admitted to the cardiology unit of a health care facility for ventricular arrhythmia. In which of the following conditions can an antiarrhythmic drug be safely administered?
- A. Aortic stenosis
- B. Premature ventricular contraction
- C. Third-degree heart block
- D. Severe heart failure
Correct Answer: B
Rationale: The nurse can safely administer an antiarrhythmic drug if the client has premature ventricular contractions. Aortic stenosis, third-degree heart block, and severe congestive heart failure are contraindications for the use of antiarrhythmic drugs.
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 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.
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.