Question 1

Which is an adverse effect associated with the use of procainamide (Procan SR)?&#10;A)Tinnitus&#10;B)Shortened QT interval&#10;C)Constipation&#10;D)Diarrhea

Accepted Answer

Diarrhea is a potential adverse effect of procainamide therapy.

Question 2

What should be monitored closely in a patient who is taking Class IV antidysrhythmics?&#10;A)Urine output and specific gravity&#10;B)Temperature and skin turgor&#10;C)Heart rhythm and blood pressure&#10;D)Level of consciousness

Accepted Answer

Patients receiving Class IV antidysrhythmics initially or having their doses altered must have their heart rhythm monitored by electrocardiography.In addition,blood pressure and other vital signs need to be monitored frequently.

Question 3

A patient will be discharged on quinidine sulphate (Apo-Quin-G)extended-release tablets for the treatment of ventricular ectopy.What important information should the nurse give the patient about this medication?

A)The medication should be stopped once the cardiac symptoms subside.
B)Signs of cinchonism (such as tinnitus, loss of hearing, or slight blurring of vision) may occur.
C)Because of increased photosensitivity, sunscreen products should be used when outside.
D)Any tablet or capsule visible in the stool indicates an absorption problem and should be reported immediately.

Accepted Answer

Quinidine,a cinchona alkaloid,may cause the symptoms of cinchonism.The medication will need to be continued even after symptoms subside,or the symptoms may return.Tablets or capsules that are visible in the stool are actually the wax matrixes; the medication is extracted while in the intestines.Photosensitivity occurs with Class III drugs but not with quinidine,which is a Class Ia drug.

Question 4

Which medication can cause a systemic lupus erythematosus-like syndrome in about 30% of patients?&#10;A)lidocaine&#10;B)procainamide hydrochloride&#10;C)atenolol&#10;D)propranolol

Accepted Answer

Procainamide hydrochloride (Procan SR)can cause a systemic lupus erythematosus-like syndrome,which occurs in approximately 30% of patients on long-term therapy.

Question 5

What is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction (MI)?&#10;A)diltiazem (Cardizem)&#10;B)metroprolol tartrate (Lopressor)&#10;C)amiodarone hydrochloride (Cordarone)&#10;D)adenosine (Adenocard)

Accepted Answer

Amiodarone hydrochloride (Cordarone)is the drug of choice for ventricular dysrhythmias according to the Advanced Cardiac Life Support guidelines.Recently,it has shown promise in the management of atrial dysrhythmias that are difficult to treat with other,less toxic drugs.Metroprolol tartrate (Lopressor)is a b-blocker commonly given after an MI to reduce the risk of sudden cardiac death.It is also used in the treatment of hypertension and angina.Adenosine (Adenocard)is indicated for the conversion of paroxysmal supraventricular tachycardia (PSVT)to sinus rhythm,and diltiazem is used for treating dysrhythmias and controlling the ventricular response to atrial fibrillation and flutter by slowing conduction and prolonging refractoriness of the atrioventricular node.

Question 6

The Vaughan Williams classification categorizes amiodarone as a Class III drug.How does this drug work?&#10;A)By blocking slow calcium channels&#10;B)By prolonging action potential duration&#10;C)By blocking sodium channels and affecting phase 0&#10;D)By decreasing spontaneous depolarization and affecting phase 4

Accepted Answer

These drugs control dysrhythmias by inhibiting repolarization and by prolonging refractoriness and the action potential duration.

Question 7

Which nursing diagnosis is appropriate for a patient receiving antidysrhythmics?&#10;A)Risk for infection&#10;B)Risk for injury to self&#10;C)Excess fluid volume&#10;D)Impaired skin integrity

Accepted Answer

Dizziness,fatigue,and orthostatic hypotension are possible adverse effects that may cause injury and put the patient at risk for falls.

Question 8

Which instructions are appropriate for the nurse to give a patient who is taking an antidysrhythmic drug? (Select all that apply.)
(Indicate your answer with small letters,and a comma followed by a space [e.g.,a,b,c,d]).

A)Do not chew or crush extended-release forms of medication.
B)Capsules may be opened if they cannot be swallowed.
C)Take the medication with food if gastrointestinal distress occurs.
D)If a dose is missed, the missed dose should be taken with the next dose that is due.
E)Take the medications with an antacid if gastrointestinal distress occurs.
F)Limit or avoid the use of caffeine.g.The presence of a capsule in the stool should be reported to the physician immediately.

Accepted Answer

"Do not chew or crush extended-release forms of medication," "Take the medication with food if gastrointestinal distress occurs," and "Limit or avoid the use of caffeine" are appropriate instructions to a patient who is taking an antidysrhythmic drug.Capsules should not be opened,and medications should not be taken with an antacid.What appears to be a portion of a capsule or tablet in the stool is actually the wax matrix that carried the medication,which has been absorbed,and the physician does not need to be notified.Medication doses should not be doubled.

Question 9

A patient has been started on lidocaine (Xylocaine).The nurse will monitor the patient for which adverse effect of this drug?&#10;A)Drowsiness&#10;B)Nystagmus&#10;C)Dry mouth&#10;D)Convulsions

Accepted Answer

Convulsions are possible with an overdose of lidocaine.

Question 10

The nurse needs to administer adenosine (Adenocard)to a patient who is experiencing an acute episode of PSVT.What important information should the nurse remember when giving this medication?&#10;A)The onset of action occurs in 5 minutes.&#10;B)The medication must be given as a slow intravenous (IV) push.&#10;C)Asystole may occur for a few seconds after administration.&#10;D)The medication has a long half-life, and the duration of action is very long.

Accepted Answer

A very brief episode of asystole may occur after administration of adenosine.Adenosine has an extremely short half-life of less than 10 seconds,its onset occurs within 1 minute,and it must be given as a fast IV push medication.

Deck 26: Antidysrhythmic Drugs