Download Pharmacology Antidysrhythmics Test with 100% Verified Solutions | Updated & Verified | 20 and more Exams Nursing in PDF only on Docsity!
Pharmacology Antidysrhythmics Test with 100%
Verified Solutions | Updated & Verified | 2024
- treats atrial and ventricular tachydysrhyhmias
- adverse effects: dysrhythmias, blood disorders, lupus like syndrome, vomiting, diarrhea, prolonged QT interval, - ✔✔Procainamide (Pronestyl)
- Class Ib
- block sodium channels
- accelerate repolarization
- increase or decrease APD
- used for atrial and ventricular tachydysrhythmias caused by digitalis toxicity or prolonged QT interval - ✔✔Phenytoin
- used to treat ventricular tachydysrhythmias
- raises ventricular fibrillation threshold
- can cause twitching, convulsions, confusion, respiratory depression, hypotension, bradycardia, dysrhythmias - ✔✔Lidocaine (Xylocaine)
- more pronounced effect on blocking sodium channels
- class Ic
- has little effect on APD or repolarization
- used for severe ventricular dysrhythmias
- first line drug in treatment of afib
- negative inotropic effect and depresses left ventricle
- contraindicated in hypersensitivity, cardiogenic shock, second or third degree AV block and non-life threatening dysrhythmias - ✔✔Flecainide Beta blockers
- depressants for both supraventricular and ventricular dysrhythmias - ✔✔Class II Antidysrhythmics
- cardioselective beta blocker
- contraindications severe bradycardia, second and third degree heart block, cardiogenic shock or hypersensitivity - ✔✔Atenolol
- increase APD
- prolong repolarization of phase 3
- used for dysrhythmias that are difficult to treat - ✔✔Class III Antidysrhythmics
- one of the most effective drugs for controlling supraventricular and ventricular drugs
- drug of choice for controlling ventricular dysrhythmias
- adverse effects: corneal microdeposits, photophobia, dry eyes, halos, pulmonary toxicity contraindications: severe sinus bradycardia, second or third degree heart block, hypersensitivity - ✔✔Amiodarone Calcium channel blockers
- depress phase 4 repolarization
- reduce AV node conduction
Dizziness Headache, and blurred vision Prolongation of the QT interval - ✔✔Antidysrhythmic side effects Coumadin: monitor international normalized ratio Grapefruit juice: amiodarone, disopyramide, and quinidine - ✔✔Drug interactions Obtain a thorough drug and medical history. Measure baseline blood pressure (BP), pulse, input and output, and cardiac rhythm. Measure serum potassium levels before initiating therapy. During therapy, monitor cardiac rhythm, heart rate, BP, general well-being, skin color, temperature, and heart and lung sounds. Assess plasma drug levels as indicated. Monitor for toxic effects. - ✔✔Nursing implications Ensure that the patient knows to notify health care provider of any worsening of dysrhythmia or toxic effects Shortness of breath Edema Dizziness Syncope Chest pain Gastrointestinal distress
Blurred vision Edema - ✔✔When to notify HCP Teach patients taking beta blockers, digoxin, and other drugs how to take their own radial pulse for 1 full minute and to notify their physicians before taking the next dose if the pulse is less than 60 beats/min. - ✔✔What to teach patient taking beta blockers and digoxin Monitor ECG for prolonged QT interval with use of antidysrhythmics, including amiodarone, procainamide, quinidine, dofetilide, bepridil, sotalol, and flecainide. - ✔✔What to monitor ECG for while taking these drugs Solutions of lidocaine that contain epinephrine should not be given IV; they are to be used ONLY as local anesthetics. - ✔✔Lidocaine implications Decreased BP in hypertensive patients Decreased edema Decreased fatigue Regular pulse rate Pulse rate without major irregularities Improved regularity of rhythm Improved cardiac output - ✔✔Therapeutic response of antidysrhythmic drugs C
A. class Ic drug B. class II drug C. class III drug D. class IV drug C Use of amiodarone is contraindicated in clients who have a known hypersensitivity to the drug. Altered skin integrity, elevated temperature, and decreased of increased respiratory rate are not contraindications. The other absolute contraindications include severe sinus bradycardia or second- or third- degree heart block. - ✔✔Before administering amiodarone, what is the most important assessment for the nurse to complete? A. Skin integrity B. Temperature C. Allergy history D. Respiratory rate C The patient who is being treated with these medications should maintain a well-balanced diet and avoid consuming an excessive amount of alkaline ash foods, such as citrus fruits, vegetables, and milk. - ✔✔Which food selection would be an inappropriate choice for a patient undergoing treatment with an antidysrhythmic drug? A. Turkey sandwich B. Bacon and eggs C. Chef salad D. Hamburger with onions
B
A patient who is prescribed procainamide (Pronestyl) may develop hypotension; therefore, the nurse should measure the patient's blood pressure (BP) regularly to assess for this complication. Bradycardia is an adverse effect of lidocaine (Xylocaine). Thrombophlebitis is an adverse effect of phenytoin (Dilantin). A patient who is on flecainide (Tambocor) might experience visual disturbances. - ✔✔A nurse is caring for a patient who is prescribed procainamide (Pronestyl). Which nursing action is the priority when providing care to the patient? A. Monitoring for tachycardia B. Measuring blood pressure regularly C. Assessing for signs of thrombophlebitis D. Asking the patient about any changes in vision B Hypothyroidism or hyperthyroidism may develop as a result of taking the medication as a result of its lipophilic nature and the use of iodine in its chemical structure. - ✔✔The nurse is caring for patient who is being treated with amiodarone (Cordarone). After 6 weeks on the medication, lab work is drawn on the patient and shows evidence of hypothyroidism developing. The nurse interprets this information to mean A. the patient is developing an anaphylactic reaction to the medication B. this is an expected adverse reaction to the medication C. this is indicative of an inadequate dosage of the medication D. this is indicative of a toxic dosage of the medication B
repolarization in phase 3. Lidocaine (Xylocaine) blocks sodium channels, which delays repolarization and increases the action potential duration. - ✔✔Which medication acts by blocking calcium channels? A. Digoxin (Lanoxin) B. Ibutilide (Corvert) C. Diltiazem (Cardizem) D. Lidocaine (Xylocaine) B Sotalol (Betapace) increases the action potential duration by prolonging repolarization in phase 3. It also has beta-blocking properties. Verapamil (Calan) acts by blocking the calcium channels. Flecainide (Tambocor) blocks the sodium channel, but does not have a pronounced effect on the duration of the action potential or repolarization. Adenosine (Adenocard) acts by several mechanisms and does not fall under one particular category. - ✔✔Which medication increases the duration of the action potential by prolonging repolarization in phase 3? A. Verapamil (Calan) B. Sotalol (Betapace) C. Flecainide (Tambocor) D. Adenosine (Adenocard) C Metoprolol (Lopressor) is a beta blocker and might cause dry mouth and wheezing as a side effect; therefore, the nurse should teach the patient about methods to manage dry mouth and wheezing. A patient who is taking ibutilide (Corvert) might experience nonsustained ventricular tachycardia, but not dry mouth. A patient who is taking quinidine (Quinidex) might experience hypotension and a prolonged QT interval, but not dry mouth or wheezing. A patient who is taking amiodarone (Cordarone) might
experience pulmonary toxicity. - ✔✔Which medication would make a patient most prone to dry mouth and wheezing? A. Ibutilide (Corvert) B. Quinidine (Quinidex) C. Metoprolol (Lopressor) D. Amiodarone (Cordarone) B Lidocaine is a sodium channel-blocking drug used specifically to treat ventricular arrhythmias. - ✔✔A patient has been prescribed lidocaine (Xylocaine). What does the nurse understand as the reason for this medication order? A. Bradycardia B. Ventricular arrhythmias C. Atrial arrhythmias D. Heart block A Adenosine must be given as rapidly as possible, followed by a 50-mL normal saline flush in order to get all of the medication into the circulation quickly since the half-life of adenosine is less than 10 seconds. - ✔✔The nurse is reviewing emergency protocols and administration of adenosine (Adenocard). What is a vitally important task to remember when administering adenosine? A. Give it as a rapid intravenous push. B. Give it at the highest port in the IV tubing. C. Offer it with food or milk. D. Prepare to set up for an intravenous drip infusion.
D. Class IV B. Ibutilide is specifically indicated only for treatment of recent-onset atrial fibrillation and flutter. - ✔✔The patient has been prescribed ibutilide (Corvert), a class III antiarrhythmic drug. The nurse is aware that this drug has been prescribed for which reason? A. Treatment of PSVT B. Conversion of recent-onset atrial fibrillation and flutter C. Conversion of life-threatening ventricular arrhythmias D. Treatment of dysrhythmias in patients with acute renal failure C Antiarrhythmic drugs can cause both hypotension and bradycardia; therefore it is important to assess blood pressure and apical pulse before administration. Peripheral pulses are not as reliable as the apical pulse assessment. - ✔✔Before administering a dose of an antidysrhythmic drug to an assigned patient, which assessments would be of highest priority? A. Urine output and specific gravity B. Temperature and pulse rate C. Apical pulse and blood pressure D. Peripheral pulses and level of consciousness C Calcium channel blockers are effective in treating both hypertension and dysrhythmias secondary to their negative inotropic and chronotropic effects. - ✔✔Which class of drugs is used to treat both hypertension and dysrhythmias?
A. Sodium channel blockers B. Calcium channel blockers C. Angiotensin-converting enzyme (ACE) inhibitors D. Direct-acting vasodilators B Calcium channel blockers cause coronary vasodilation, a negative inotropic effect, a negative chronotropic effect, and a negative dromotropic effect. - ✔✔Calcium channel blockers have which pharmacodynamic effect? A. Positive inotropic effect B. Coronary vasodilation C. Positive chronotropic effect D. Shortened refractory period C Patients taking amiodarone must have baseline and serial pulmonary function tests in order to monitor for potential pulmonary toxicity. - ✔✔The most severe adverse effects of amiodarone are evidenced in which body system? A. Renal B. Hepatic C. Pulmonary D. Hematologic A, C, D
