Medications for arrhythmias

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Question 1:

A nurse is caring for a client who is prescribed quinidine for the treatment of arrhythmias. Which of the following should the nurse monitor for as an adverse effect of this medication?

Explanation

Quinidine is an antiarrhythmic medication that can cause hypokalemia (low potassium levels) as an adverse effect. Potassium is an electrolyte that is important for the normal functioning of the heart and muscles.Hypokalemia can cause arrhythmias, muscle weakness, cramps, and fatigue.

Choice A is wrong because quinidine does not cause hypertension (high blood pressure).In fact, quinidine can lower blood pressure by dilating blood vessels and reducing the force of heart contractions.Normal blood pressure ranges are less than 120/80 mm Hg for systolic and diastolic pressures, respectively.

Choice B is wrong because quinidine does not cause hypoglycemia (low blood glucose levels).Quinidine does not affect insulin secretion or glucose metabolism.Normal blood glucose ranges are 70 to 99 mg/dL (3.9 to 5.5 mmol/L) before meals and less than 140 mg/dL (7.8 mmol/L) two hours after meals.

Choice D is wrong because quinidine does not cause hypernatremia (high sodium levels).Quinidine does not affect sodium balance or excretion. Sodium is another electrolyte that is important for fluid balance, nerve impulses, and muscle contractions.Hypernatremia can cause thirst, confusion, seizures, and coma.Normal sodium ranges are 135 to 145 mEq/L (135 to 145 mmol/L).


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Question 2:

A nurse is caring for a client who is prescribed amiodarone for the treatment of arrhythmias. Which of the following should the nurse monitor for as an adverse effect of this medication? (Select all that apply)

Explanation

Amiodarone is a medication used to treat irregular heartbeats, but it can cause various adverse effects, such as:

• Photosensitivity, which means increased sensitivity of the skin to sunlight and risk of sunburn.

This can be prevented by wearing protective clothing and sunscreen when outdoors.

• Pulmonary toxicity, which means damage to the lungs that can cause inflammation, scarring, or difficulty breathing.

This can be fatal in some cases and requires regular monitoring of chest X-rays and pulmonary function tests.

• Thyroid dysfunction, which means abnormal levels of thyroid hormones that can affect metabolism, energy, and mood.

This can be either hypothyroidism (low thyroid hormone) or hyperthyroidism (high thyroid hormone) and requires regular monitoring of thyroid function tests.

Choice A and B are wrong because amiodarone can causebradycardia(slow heartbeat) andhypotension(low blood pressure), not the opposite.

These effects can be serious and require close monitoring of heart rate and blood pressure.


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Question 3:

A nurse is caring for a client who is prescribed lidocaine for the treatment of arrhythmias. Which of the following should the nurse monitor for as an adverse effect of this medication?

Explanation

This is because lidocaine is a local anesthetic that can cause various side effects, some of which may be serious and require emergency medical help.These include difficulty breathing, swelling of the face, lips, tongue, or throat, twitching, tremors, seizure, a light-headed feeling, slow heart rate, weak pulse, weak or shallow breathing, and sudden feeling of warmth with muscle stiffness and pain.Dizziness is a common sign of central nervous system (CNS) excitation and/or depression caused by lidocaine.

Choice B is wrong because “My mouth feels dry” is wrong because dry mouth is not a typical side effect of lidocaine.Dry mouth can be caused by dehydration, medications, salivary gland problems, or other medical conditions.

Choice C is wrong because “My urine is dark” is wrong because dark urine is not a common side effect of lidocaine.Dark urine can be a sign of dehydration, liver problems, blood in the urine, or other health issues.Normal urine color ranges from clear to pale yellow.

Choice D is wrong because “I have a headache” is wrong because headache is not a usual side effect of lidocaine.Headache can be caused by many factors, such as stress, lack of sleep, dehydration, or other medical conditions.

Some additional sentences are:

assistantIf you are prescribed lidocaine for the treatment of arrhythmias, you should monitor for any signs of adverse effects and seek medical help if they occur.

You should also follow the dosage instructions carefully and avoid taking more than the recommended amount.Lidocaine can interact with some other medications, so you should inform your doctor about any other drugs you are taking.


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Question 4:

A client who has been prescribed propranolol for the treatment of arrhythmias reports experiencing shortness of breath and difficulty breathing while lying down at night. Which of the following should the nurse instruct the client to do?

Explanation

This can help to elevate the chest and open up the airways, reducing shortness of breath and difficulty breathing.Propranolol is a beta blocker that can cause side effects such as slower heart rate, fatigue, dizziness, cold hands and feet, and Raynaud’s phenomenon. These side effects can worsen breathing problems, especially when lying down flat.

Choice B is wrong because sleeping on the left side may not be enough to improve breathing.It may also cause more pressure on the heart and lungs, which can affect blood circulation and oxygen delivery.

Choice C is wrong because sleeping on the right side may not be helpful for breathing either.Some research suggests that sleeping on the right side can make breathing more difficult for some people with obstructive sleep apnea.

Choice D is wrong because sleeping on the back can increase snoring, sleep apnea, and reflux symptoms, which can all interfere with breathing.Sleeping on the back can also cause the tongue and soft palate to block the airway, reducing oxygen intake.


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Question 5:

A nurse is caring for a client who is prescribed verapamil for the treatment of arrhythmias. Which of the following should the nurse monitor for as an adverse effect of this medication?

Explanation

Verapamil is a medication that belongs to a class of drugs called calcium channel blockers, which are used to treat high blood pressure, angina, and arrhythmias. Verapamil works by relaxing the blood vessels and slowing down the heart rate, which lowers blood pressure and reduces the workload of the heart. However, verapamil can also affect the smooth muscles of the digestive tract, causing them to contract less frequently and forcefully.This can lead to constipation, which is a common side effect of verapamil.

Choice A is wrong because verapamil does not cause hypertension, but rather lowers blood pressure.In fact, verapamil can sometimes cause hypotension, which is abnormally low blood pressure.

Choice B is wrong because verapamil does not cause hyperkalemia, which is a high level of potassium in the blood.Verapamil can actually lower potassium levels by increasing its excretion in the urine.Hyperkalemia can be caused by other medications, such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or potassium-sparing diuretics.

Choice C is wrong because verapamil does not cause hypoglycemia, which is a low level of glucose in the blood.Verapamil does not affect insulin secretion or glucose metabolism.Hypoglycemia can be caused by other medications, such as insulin or sulfonylureas, or by fasting, alcohol consumption, or exercise.

The normal ranges for blood pressure, potassium, and glucose are as follows:

• Blood pressure: less than 120/80 mm Hg (millimeters of mercury) when fasting and less than 140/90 mm Hg two hours after eating for people without diabetes; less than 130/80 mm Hg for people with diabetes.

• Potassium: 3.6 to 5.2 mmol/L (millimoles per liter) or 3.6 to 5.2 mEq/L (milliequivalents per liter).

• Glucose: less than 100 mg/d


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