Pharm Chp 25

The nurse is caring for a patient receiving lidocaine IV. Which factor is most relevant to administration of this medication?

Presence of premature ventricular contractions (PVCs) on cardiac monitor

A 92-year-old patient is being sent home on disopyramide (Norpace) for a ventricular arrhythmia. He asks you why he must continue to take this drug. Your best response would be that a ventricular arrhythmia may what?

Result in death

An antiarrhythmic drug is prescribed for a client whose apical pulse rate is 100. What is the nurse's best action?

Administer the medication with water.

You are caring for a client who is receiving lidocaine, a Class 1B antiarrhythmic drug. What type of arrhythmia is this class of drugs used to treat?

All acute ventricular arrhythmias

A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is necessary?

"I am going on a cruise next week and plan to just lie in the sun all day and relax."

A client diagnosed with heart disease is prescribed an antiarrhythmic drug. Further teaching is needed when the client makes which of the following statements?

"I know I must take my medication every day to be cured."

A physician has ordered lidocaine IV for a patient with a ventricular dysrhythmia. The nurse has administered a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV?

1-4 mg/min

After you have administered a bolus of lidocaine, you will run a continuous infusion at which rate?

1-4 mg/min

The primary health care provider prescribes sotalol (Betapace) 80 mg BID orally. The drug is available in 40 mg tablets. The nurse will administer how many tablets in 24 hours?

4

A nurse is required to monitor the blood concentration levels of the drug in a patient receiving IV lidocaine for cardiac arrhythmia. Which of the following blood concentration levels should alert the nurse to report to the healthcare provider immediately?

6 mcg/mL

Which of the following medications are Class II antiarrhythmics? (Select all that apply)

Acebutolol (Sectral) Propranolol (Inderal)

After teaching group of students about antiarrhythmic agents, the instructor determines that the teaching was successful when the students identify which of the following as examples of class III antiarrhythmics? Select all that apply.

Amiodarone Dofetilide Sotalol Ibutilide

A patient is administered amiodarone (Cordarone) intravenously. Which of the following assessments is most important with this medication?

Assess blood pressure every 5 minutes

A client taking verapamil (Calan) complains of a sore throat. What is the nurse's first action?

Assess for fever, chills, or bruising.

You are caring for a patient who is hospitalized with a life-threatening dysrhythmia. As a nurse, what intervention can you make to assess the hemodynamic effects of a dysrhythmia on your patient?

Assess the patient's BP and pulse rate

A patient receiving warfarin is prescribed disopyramide. The nurse would monitor for signs and symptoms of which of the following as most important?

Bleeding

Which statement would be true about the mechanism of action of class II antiarrhythmic agents?

Block the stimulation of the adrenergic receptors

The client receiving propranolol (Inderal) at home for management of a ventricular dysrhythmia should monitor which of the following parameters?

Blood pressure daily

When describing the drugs classified as class IV antiarrhythmics, the nurse would identify these as which of the following?

Calcium channel blockers

A client taking disopyramide (Norpace) has a low total urinary output during the past eight hours. What is the nurse's first action?

Check the fluid intake amount for the last eight hours.

You are caring for a patient who takes an antidysrhythmic. What would be a priority nursing action before administering this drug?

Check the patient's apical and radial pulses

A patient with impaired renal function is to receive dofetilide (Tikosyn) for conversion of atrial fibrillation. Which of the following should the nurse do before administering the drug?

Check the patient's creatinine level

Flecainide (Tambocor) is classified as which type of antiarrhythmic? (Choose one)

Class IC

A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine) per IV infusion pump for an acute ventricular arrhythmia associated with an acute MI. Which of the following patient manifestations would cause the nurse to notify the physician immediately?

Confusion

A client complains of difficulty swallowing an antiarrhythmic capsule. What is the nurse's best response?

Contact the pharmacist about trying a different form of the medication.

A stable patient with atrial flutter is symptomatic from the arrhythmia. The physician administers dofetilide (Tikosyn) IV in an attempt to what?

Convert the arrhythmia to a sinus rhythm

A client is prescribed propranolol (Inderal). Which condition in the client's history may affect the treatment regimen?

Elevated glucose

An older adult is prescribed an antiarrhythmic drug. The nurse should immediately report which of the following adverse effects?

Decrease in urinary output and weight gain.

What is an adverse effect of propranolol therapy?

Diarrhea

Discharge counseling for clients taking antiarrhythmic medications should include which of the following? (Choose one)

Do not take any nonprescription medications without permission of the physician. Keep all appointments with the physician. To relieve dry mouth take frequent sips or water or chew (sugar-free) gum.

A patient is receiving an antidysrhythmic medication intravenously. How often should the patient's blood pressure be assessed?

Every 1-5 minutes

Mr. Franks, a 68-year-old male, is treated with lidocaine for frequent premature ventricular contractions after a myocardial infarction. The nurse knows that she needs to assess Mr. Franks frequently for adverse reactions that are dose related. What are the most common mild adverse effects of lidocaine therapy?

Fatigue

There are four primary classes of antidysrhythmic drugs. What class consists primarily of potassium channel blockers?

III

There are several classes of antiarrhythmic drugs. What class of antiarrhythmics drugs block potassium channels, prolonging phase 3 of the action potential, and slowing the rate and conduction of the heart?

III

Lidocaine (Xylocaine) is available in a variety of dosage forms. How should a nurse administer lidocaine to a client with a ventricular arrhythmia? (Choose one)

Intravenously

A patient is admitted to the emergency department in ventricular fibrillation. The patient is administered amiodarone hydrochloride (Cordarone). What is the major effect of this medication?

It slows the conduction through the AV node.

The administration of ciprofloxacin (Cipro) and disopyramide (Norpace) can result in which of the following? (Choose one)

Life threatening-arrhythmias

You are a critical care nurse caring for a patient after open-heart surgery. What nursing intervention would you initiate to help detect life-threatening dysrhythmias and manage and minimize any that occur?

Monitor cardiac rhythm continuously

Ms. Smith is started on antiarrhythmic therapy to treat atrial fibrillation. As the nurse caring for Ms. Smith, you know that which occurrence is a potential side effect of this medication?

Other arrhythmias

What is the safest precaution to take when administering an antiarrhythmic drug intravenously (IV)?

Place the client on a cardiac monitor.

Which one of the following antidysrhythmic drugs is also used to treat a myocardial infarction?

Propranolol (Inderal)

A patient complains of ringing in the ears and hearing loss following treatment for cardiac arrhythmia. Which of the following drugs should the nurse consider as a possible cause of these adverse effects?

Quinidine

A patient with a history of atrial fibrillation has had a worsening of their condition. The nurse knows that the drug of choice for long-term stabilization of atrial fibrillation is what?

Quinidine (Generic)

A patient has been prescribed disopyramide (Norpace) to treat a tachydysrhythmia. Which of the following factors would necessitate that the dose be reduced?

Renal impairment

Which of the following factors would necessitate a reduction in the dosage of disopyramide?

Renal impairment

Which of the following factors would necessitate that the dosage of disopyramide (Norpace) be reduced?

Renal impairment

A patient has a complex cardiac history that includes recurrent ventricular fibrillation. After the failure of more conservative treatments, his care team has introduced oral amiodarone. What assessments should be prioritized by the nurse who is providing care for this patient?

Respiratory assessment

You are discussing possible adverse effects of quinidine with a client who has been prescribed the drug. Which of the following would you mention in your discussion?

Ringing in the ears

Ms. Jones, 32 years old, has been admitted to the hospital for cardiac dysrhythmias. The nurse understands that the heart has a specialized electrical system, with the pacemaker of the heart in what location?

Sinoatrial node

What would the nurse teach the patient to monitor for whenbeginning an antidysrhythmic drug regimen?

Syncope

What procedures should a nurse teach a client with dysrhythmia to perform to evaluate his or her response to treatment?

Technique for palpating and counting the pulse

You are giving an intravenous infusion of amiodarone (Cordarone). What should you as the nurse be aware of?

The possible development of very serious cardiac arrhythmias

A nurse is the cardiac care unit is preparing to hang an intravenous dose of dofetilide (Tikosyn) for a patient who has just been admitted. What is the most likely goal of this intervention?

To convert the patient's atrial fibrillation to normal sinus rhythm

The teaching plan for a client taking amiodarone should include which instruction?

Use a reliable form of birth control while taking this medication.

After successful treatment for a myocardial infarction, a 69-year-old man has developed a ventricular arrhythmia. His care team has opted for treatment with a Class II antiarrhythmic. The nurse would understand that this patient is likely to be prescribed

acebutolol

Propranolol is ordered for a patient who has a cardiac arrhythmia. It will be important for the nurse to determine if the patient has a history of

hypersensitivity to beta blockers.

You are administering lidocaine to a client with ventricular tachycardia. You know that you must observe for adverse effects, including

hypotension

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by

inhibiting the movement of calcium ions across the cardiac muscle cell membrane.