A client is prescribed oral amiodarone for recurrent ventricular dysrhythmias. The nurse should teach the client to notify the physician if which symptom develops?

Edema of ankles

Shortness of breath

Fatigue after exercise

Abdominal fullness

Answer and Explanation

The Correct Answer is B

A. Edema of ankles: While peripheral edema may be associated with worsening cardiac function or side effects from other medications, it is not a hallmark adverse effect of amiodarone. It warrants evaluation but is not the most urgent symptom related to this drug.

B. Shortness of breath: Amiodarone is a potent antiarrhythmic medication with several potential serious side effects, including pulmonary toxicity. This can manifest as interstitial pneumonitis or pulmonary fibrosis, which may present as new or worsening shortness of breath cough, and chest pain. This is a potentially life-threatening complication and requires immediate medical attention.

C. Fatigue after exercise: Exercise-induced fatigue can result from many conditions, including heart disease or deconditioning, but it is a nonspecific symptom. It does not point directly to a serious adverse reaction from amiodarone.

D. Abdominal fullness: Abdominal fullness is not typically associated with amiodarone. It may relate to gastrointestinal or hepatic issues, but it is not as immediately concerning as respiratory symptoms suggestive of pulmonary toxicity.

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Correct Answer is D

Explanation

A. Maintain the infusion because the client had a cardiac arrest: While epinephrine is essential during cardiac arrest, continuing a high-dose infusion post-resuscitation without reassessment may lead to complications like tachycardia, hypertension, and increased myocardial oxygen demand.

B. Continue to monitor the client's rhythm closely: Ongoing monitoring is important, but it is a passive intervention. The heart rate of 120 bpm may reflect excessive adrenergic stimulation from epinephrine, and further action is needed to prevent deterioration.

C. Suggest that the client's medication be changed to norepinephrine: Norepinephrine is another vasopressor that has less of a beta-1 adrenergic effect compared to epinephrine. It is primarily used for hypotension and septic shock, not as a direct substitute for epinephrine post-cardiac arrest. Changing to another vasopressor without indication is not the best initial step.

D. Ask the physician if the dose can be decreased: A heart rate of 120 bpm may indicate that the epinephrine dose is too high, causing sympathetic overstimulation. Prolonged or excessive tachycardia increases myocardial oxygen demand, which can be detrimental, especially in a post-arrest heart. Decreasing the dose can help prevent arrhythmias or myocardial ischemia, making this the most appropriate and proactive action.

A. Blood pressure reading of 120/80 B. Urine output 30 mL for one hour C. Serum sodium level is 135 mEq/L (135-145) D. Respiratory rate 16 per minute

Correct Answer is D

Explanation

A. Blood pressure reading of 120/80: While a normal blood pressure is desirable, this value alone does not indicate improvement in fluid overload or pulmonary symptoms. It may remain normal even if respiratory status worsens or fails to improve.

B. Urine output 30 mL for one hour: Although urine output is an important measure of diuretic effectiveness, 30 mL/hr is the minimum acceptable rate, not necessarily a strong indicator of clinical improvement. More robust diuresis may be expected following IV furosemide.

C. Serum sodium level is 135 mEq/L (135–145): A normal sodium level reflects stable electrolyte status but does not directly indicate improvement in pulmonary congestion or dyspnea. Sodium may be affected by many factors unrelated to heart failure symptom relief.

D. Respiratory rate 16 per minute: A decrease in respiratory rate from 26 to 16 suggests improved oxygenation, reduced pulmonary congestion, and decreased work of breathing. It is the most direct and clinically relevant indicator of symptomatic improvement in this context.

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A client is prescribed oral amiodarone for recurrent ventricular dysrhythmias. The nurse should teach the client to notify the physician if which symptom develops?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who has been successfully resuscitated following a cardiac arrest and is now on an IV infusion of epinephrine. The cardiac monitor shows a heart rate of 120 beats/minute. What should be the nurse's best action?

Correct Answer is D

Explanation

The client with heart failure exhibits bibasilar crackles, dyspnea and a respiratory rate of 26/min. The physician prescribes furosemide 40 mg IV and enalapril 5 mg PO. Which parameter would the nurse use to best evaluate if the client is responding to these medications?

Correct Answer is D

Explanation

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