Class I Antidysrhythmic Therapy (Sodium Channel Blockers)

Question 6 of 12 A nurse is preparing quinidine to administer to a patient with ventricular dysrhythmia. Which dose of quinidine would cause the nurse to notify the health care provider before administering? 100 mg every 4 hours 324 mg every 8 hours 324 mg every 12 hours 648 mg every 8 hours

100 mg every 4 hours The usual dose for quinidine is 324 to 648 mg every 8 to 12 hours. This dose is too low, and the nurse would be expected to notify and discuss with the health care provider before administering the drug.

Question 3 of 12 Which time frame after administration of flecainide would the nurse expect the onset of action to occur? 15 minutes 3 hours 12 to 27 hours 1 to 2 days

3 hours Flecainide's onset is 3 hours.

Question 1 of 12 The patient with which medical condition will most likely benefit from lidocaine administered intravenously? Acute ventricular tachycardia Deep laceration to the leg Atrial fibrillation Dental caries

Acute ventricular tachycardia Lidocaine administered intravenously is indicated for patients with ventricular dysrhythmias, such as acute ventricular tachycardia.

Question 11 of 12 A nurse administering flecainide to a patient with sustained ventricular tachycardia will monitor the patient for which adverse drug effect? Hypotension Diarrhea Angioedema Insomnia

Angioedema Angioedema is an adverse drug effect of flecainide. Other adverse drug effects include worsening of arrhythmia, heart failure, seizures, and pulmonary toxicity.

Question 7 of 12 A patient with a ventricular dysrhythmia is to receive lidocaine. The health care provider prescribes a lidocaine bolus at 250 mg, which may be repeated in 5 minutes. This is to be followed by a maintenance lidocaine drip at 2 mg/minute for 24 hours. For which part of the prescription will the nurse require clarification? Bolus dose of 250 mg Bolus dose can be repeated in 5 minutes Maintenance dose of 2 mg/minute Duration of lidocaine of 24 hours

Bolus dose of 250 mg The bolus dose should be between 50 to 100 mg. This dose can be repeated in 5 minutes. 250 mg is too high for a single dose.

Question 4 of 12 Before administering quinidine, the nurse would assess the patient for which contraindication? Atrial fibrillation Complete heart block Atrial flutter Ventricular tachycardia

Complete heart block Complete heart block is a contraindication for administration of quinidine.

Question 2 of 12 The nurse will monitor for which therapeutic effect while administering quinidine? Shortened repolarization Reduced blood pressure Decreased heart rate Reduced secretions

Decreased heart rate Quinidine, a Class IA antidysrhythmic drug, slows the conduction rate and prolongs repolarization, which decreases heart rate such as in atrial fibrillation with rapid ventricular response. Decreasing heart rate is a therapeutic effect. However, the nurse will need to monitor for heart rate less than 60 beats/minute, indicating bradycardia, which is a side effect of quinidine.

Question 3 of 5 Which outcome may be the result of a drug-drug interaction when quinidine and digoxin are administered concurrently? Tachycardia due to quinidine Increased dysrhythmia due to quinidine Digoxin toxicity Heart failure

Digoxin toxicity Digoxin toxicity can occur if quinidine and digoxin are taken concurrently. Quinidine displaces digoxin, which increases serum digoxin. To reduce digoxin toxicity, the digoxin dose must be reduced.

Question 9 of 12 A patient with ventricular tachycardia and a pulse is to receive lidocaine. Before administering lidocaine the nurse will assess for which contraindications to lidocaine? Select all that apply. First-degree atrioventricular block Second-degree Mobitz I atrioventricular block Pulseless ventricular tachycardia Early heart failure Wolff-Parkinson-White (WPW) syndrome

First-degree atrioventricular block Lidocaine is indicated for ventricular dysrhythmia. Dysrhythmias from the sinoatrial or atrioventricular (AV) nodes are contraindications for lidocaine. First-degree block is a dysrhythmia from the AV node. Correct Second-degree Mobitz I atrioventricular block Lidocaine is indicated for ventricular dysrhythmia. Dysrhythmias from the sinoatrial or AV nodes are contraindications for lidocaine. Second-degree Mobitz I is a dysrhythmia from the AV node. Wolff-Parkinson-White (WPW) syndrome WPW syndrome is a genetic defect characterized by an extra electrical pathway between the atria and ventricles. WPW syndrome is a contraindication for lidocaine.

Question 8 of 12 Before the administration of quinidine, the nurse will review the patient's medication list for which other drugs that can prolong the QT interval? Select all that apply. Fluoxetine Warfarin Ciprofloxacin Flecainide

Fluoxetine Ciprofloxacin Flecainide Ondansetron

Question 4 of 5 The nurse will immediately alert the health care provider of which adverse outcome in a patient taking flecainide? Dizziness Decreased renal function Constipation Heart failure

Heart failure Heart failure and worsening arrhythmias are adverse drug effects of flecainide. Assessment of these effects would constitute a reason for the nurse to alert the health care provider.

Question 3 of 4 Which antidysrhythmic drug is indicated for pulseless ventricular tachycardia? Quinidine Flecainide Sotalol Lidocaine

Lidocaine Lidocaine is indicated for pulseless ventricular tachycardia.

Question 12 of 12 A patient who is prescribed quinidine, a Class I antidysrhythmic drug, tells the nurse that "long, hot baths are enjoyable at the end of a long work day." Which teaching will the nurse provide to the patient regarding long, hot baths? Long, hot baths are appropriate to help relax at the end of the day. Long, hot baths should be avoided because quinidine can lower the blood pressure. Avoid long, hot baths because they can cause a blood clot. Avoid long, hot baths because they increase the heart rate.

Long, hot baths should be avoided because quinidine can lower the blood pressure. Quinidine, while an antidysrhythmic drug, can also lower blood pressure. Long, hot baths promote vasodilation, which can worsen hypotension. Therefore the patient should avoid long, hot baths.

Question 2 of 5 The presence of which disease process constitutes a contraindication for quinidine antidysrhythmic therapy? Urinary tract infection Myasthenia gravis Atrial fibrillation Frequent premature ventricular contractions

Myasthenia gravis Quinidine is contraindicated in patients who are also adversely affected by anticholinergics, such as patients with myasthenia gravis.

Question 2 of 4 Which antidysrhythmic drug is indicated for atrial dysrhythmia? Flecainide Lidocaine Mexiletine Quinidine

Quinidine Quinidine is a Class IA antidysrhythmic drug indicated for atrial and ventricular dysrhythmias.

Question 10 of 12 While administering lidocaine, the nurse will monitor for which adverse drug effect? Hypertension Tachycardia Seizure Tachypnea

Seizure Seizure is an adverse drug effect of lidocaine.

Question 5 of 12 Which symptom, if reported by a patient recently started on quinidine, would the nurse find most concerning? Headache Diarrhea Dizziness Shortness of breath

Shortness of breath Shortness of breath following initiation of quinidine therapy may be a symptom of a pulmonary embolus. A clot, dislodged from the atria once sinus rhythm is reestablished, can travel to the pulmonary system and can be fatal. This symptom would be the most concerning to the nurse.

Question 1 of 4 Class IA antidysrhythmic drugs block primarily which channels? Sodium Potassium Calcium Magnesium

Sodium Class IA antidysrhythmic drugs block cardiac sodium channels. This slows the electrical impulses along the electrical pathway of the heart.

Question 5 of 5 Which electrocardiogram (ECG) change will the nurse monitor for when a patient is being treated with quinidine? Widening QRS complex Widening PR interval Increasing height of the T-wave Inversion of the P-wave

Widening QRS complex Widening of the QRS prolongs the QT interval. This finding can be indicative of quinidine toxicity; therefore it is important for the nurse to monitor for this ECG change when a patient is being treated with quinidine.

Question 1 of 5 The nurse is teaching Mr. A symptoms of cinchonism, which is related to quinidine toxicity. Which symptoms would the nurse include? Select all that apply. Tinnitus Nausea Itching Visual disturbances Shortness of breath

tinnitus Nausea Visual disturbances