Pharmacology Ch 45 (3)

Before the administration of any anti-arrhythmic, what should the nurse's pre-assessment of the client's general condition include? (Select all that apply.)

- Skin color - Orientation - Level of consciousness

When describing the action of antiarrhythmics, which effect would most likely be included?

Alteration in conductivity

A client is prescribed disopyramide. The nurse would expect to administer this drug by which route?

Oral

The nurse is preparing to administer quinidine intravenously. At what rate will the nurse administer this medication?

1 mL/min

A client experiencing a ventricular dysrhythmia has received a bolus of lidocaine. What is the recommended rate for continuous infusion of lidocaine IV now prescribed for this client?

1 to 4 mg/min

When describing the action of class II antiarrhythmics, which would the nurse include?

Blockage of beta receptors in the heart and kidneys

A nurse is preparing to administer flecainide. The nurse identifies this drug as being classified as which type of antiarrhythmic?

Class IC

Which best describes the action of class II antiarrhythmics?

Competitive block beta receptor sites in the heart and kidneys

A client is to receive esmolol. The nurse would expect to administer this agent by which route?

Intravenous

What is the rationale for administering adenosine as a bolus?

It has an exceptionally short half-life.

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

It slows the conduction through the AV node.

A client is started on antiarrhythmic therapy to treat atrial fibrillation. The nurse caring for this client knows 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)? Choose the BEST response.

Place the client on a cardiac monitor. Rationale: Counting the apical pulse before is appropriate, but being on a cardiac monitor (EEG) continuously through IV treatment allows the continued assessment and documentation of the heart rhythms.

Which antiarrhythmic drug is also used to treat a myocardial infarction?

Propranolol (Inderal)

A patient is receiving an intravenous infusion of amiodarone for treatment of ventricular fibrillation. Which is the most serious adverse effect of the medication?

Pulmonary toxicity

A patient on anti-arrhythmic drug therapy reports nausea, vomiting, abdominal pain, diarrhea, and a ringing sensation in the ears. Which drug should the nurse consider as the cause for these adverse effects?

Quinidine Rationale: The nurse should consider the drug Quinidine as the cause for these adverse effects. 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 light-headedness. Lidocaine, flecainide, and procainamide do not cause tinnitus or hearing loss as adverse effects.

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

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

A client is administered diltiazem IV, followed by propranolol IV. The nurse should assess for what potential side effect of this medication combination?

impaired myocardial contractility

The primary health care provider prescribes a class I sodium channel blocker to be given intravenously. Which drug would the nurse most likely administer?

lidocaine

The nurse should advocate for a lower-than-normal dose if the client prescribed quinidine has a history of what medical diagnosis?

liver disease