A client is to receive an intravenous dose of adenosine. What immediate response to this medication should the nurse expect?
Run of premature ventricular beats.
Short period of asystole.
Brief seizure episode.
Dramatic increase in blood pressure.
The Correct Answer is B
A. Run of premature ventricular beats: While adenosine can occasionally provoke brief ventricular ectopy, this is not its primary or most expected effect. Premature ventricular contractions may occur transiently but are not the hallmark response to this medication.
B. Short period of asystole: Adenosine briefly blocks AV node conduction and can interrupt re-entry pathways, often resulting in a short period of asystole lasting a few seconds. This is an expected effect and reflects the drug’s mechanism in terminating supraventricular tachycardia by interrupting the reentrant pathway.
C. Brief seizure episode: Adenosine does not typically cause seizures. It acts primarily on cardiac tissue and has no significant pro-convulsant effects. A seizure would be an atypical and concerning adverse reaction rather than an expected response.
D. Dramatic increase in blood pressure: Adenosine causes transient vasodilation and may lead to a brief drop in blood pressure or flushing. A dramatic increase in blood pressure would not be expected and could suggest an alternate diagnosis or drug reaction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["35"]
Explanation
Calculate the total infusion time in minutes.
Infusion time in minutes = 2 hours × 60 minutes/hour
= 120 minutes
Calculate the total number of drops to be infused.
The total volume remaining is 350 mL
Drip factor is 12 gtts/mL.
Total drops = Total volume (mL) × Drop factor (gtts/mL)
Total drops = 350 mL × 12 gtts/mL
= 4200 gtts
Calculate the IV flow rate in drops per minute (gtts/min).
IV rate (gtts/min) = Total drops / Total infusion time (minutes)
= 4200 gtts / 120 minutes
= 35
=35 gtts/min
Correct Answer is D
Explanation
A. "The diaphragmatic nerve overdrives the rapid rhythm:" The phrenic (diaphragmatic) nerve controls the diaphragm for breathing and plays no role in cardiac rhythm regulation. It is unrelated to the autonomic control of heart rate or supraventricular tachycardia (SVT) management.
B. "Vagal stimulation decreases peripheral vascular resistance:" Vagal stimulation primarily affects the heart by decreasing the rate and conduction through the AV node. Its effect on vascular resistance is minimal, making this explanation inaccurate in the context of SVT treatment.
C. "The vagus nerve increases the heart rate, overdriving the rhythm:" The vagus nerve has a parasympathetic effect, slowing down the heart rate, not increasing it. Overdrive pacing is a different concept and not related to vagal maneuvers like carotid massage.
D. "The vagus nerve slows the heart rate": The carotid sinuses in the neck contain baroreceptors that are sensitive to pressure. Massaging these sinuses stimulates the vagus nerve to release acetylcholine, which in turn slows conduction through the AV node and may terminate episodes of SVT. This response demonstrates an accurate understanding of the purpose of the procedure.
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