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Class I Antidysrhythmic Drugs – Sodium Channel Blockers (Quinidine, Lidocaine, Flecainide) | NCLEX Style Questions with Answers & Rationales | A-Graded Pharmacology Exam Guide
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The patient with which medical condition will most likely benefit from lidocaine administered
Lidocaine administered intravenously is indicated for patients with ventricular dysrhythmias, such as acute ventricular tachycardia. The nurse will monitor for which therapeutic effect while administering quinidine?
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. Which time frame after administration of flecainide would the nurse expect the onset of
Flecainide's onset is 3 hours. Before administering quinidine, the nurse would assess the patient for which
Complete heart block is a contraindication for administration of quinidine. 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
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. 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
Before the administration of quinidine, the nurse will review the patient's medication list for which other drugs that can prolong the QT interval?
Ciprofloxacin Flecainide Ondansetron A patient with ventricular tachycardia and a pulse is to receive lidocaine. Before administering lidocaine the nurse will assess for which contraindications to lidocaine?
Second-degree Mobitz I atrioventricular block Wolff-Parkinson-White (WPW) syndrome While administering lidocaine, the nurse will monitor for which adverse drug effect?
Seizure is an adverse drug effect of lidocaine.
Rationale: Flecainide can cause new or worsening heart failure. Dyspnea should be reported and assessed promptly.
Rationale: Class I drugs slow depolarization and intraventricular conduction, leading to a widened QRS complex.
Rationale: Procainamide can cause hypotension and prolonged QT intervals, so continuous ECG and BP monitoring are essential.
Rationale: Electrolyte imbalances increase the risk of arrhythmias when taking flecainide. Monitor and correct as needed.
Rationale: Class Ic drugs (flecainide, propafenone) are contraindicated in structural heart disease due to proarrhythmic risks.
Rationale: Lidocaine, especially IV, can cause neurologic symptoms (e.g., drowsiness, tingling, confusion) if toxic levels develop. A nurse administering flecainide to a patient with sustained ventricular tachycardia will monitor the patient for which adverse drug effect?
Angioedema is an adverse drug effect of flecainide. Other adverse drug effects include worsening of arrhythmia, heart failure, seizures, and pulmonary toxicity. 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