A client who was admitted with rapid atrial flutter is receiving amiodarone 1 mg/minute via a peripheral IV infusion in the left hand. The unlicensed assistive personal (UAP) reports to the nurse that the client's heart rate is 90 beats/minute and blood pressure is 110/50 mm Hg. Which intervention should the nurse implement?

Tell the UAP to turn off the amiodarone.

Evaluate rhythm of client's heat rate.

Determine regularity of peripheral pulses.

Restart the IV infusion in another site.

Answer and Explanation

The Correct Answer is B

A.   The UAP should not make medication decisions; only a nurse or healthcare provider should do this after assessment.
B.   The nurse should evaluate the client’s heart rhythm to determine the effectiveness of the amiodarone and to assess for any arrhythmias or side effects of the medication.
C.   Checking the regularity of peripheral pulses is important but secondary to assessing the heart rhythm directly.
D.   Restarting the IV infusion might be necessary if there are issues with the IV site, but the primary concern is the client's cardiac status.

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Correct Answer is A

Explanation

A. An ionized calcium level significantly above the reference range can lead to cardiac dysrhythmias and requires immediate attention to assess cardiac function.
B. While urine output and characteristics are important indicators of renal function, cardiac assessment takes priority due to the potential cardiac effects of hypercalcemia.
C. Assessment of deep tendon reflexes is relevant since hypercalcemia can lead to muscle weakness and diminished reflexes. However, this should be done after assessing for any cardiac dysrhythmias.
D. Comparing muscle strength bilaterally is important for assessing neurological integrity but is not the priority when hypercalcemia is suspected.

A. Tell the UAP to turn off the amiodarone. B. Evaluate rhythm of client's heat rate. C. Determine regularity of peripheral pulses. D. Restart the IV infusion in another site.

Correct Answer is B

Explanation

A. The UAP should not make medication decisions; only a nurse or healthcare provider should do this after assessment.
B. The nurse should evaluate the client’s heart rhythm to determine the effectiveness of the amiodarone and to assess for any arrhythmias or side effects of the medication.
C. Checking the regularity of peripheral pulses is important but secondary to assessing the heart rhythm directly.
D. Restarting the IV infusion might be necessary if there are issues with the IV site, but the primary concern is the client's cardiac status.

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Naxlex Comprehensive Predictor Exams

When assessing a client with an ionized calcium level of 17 mg/dL (4.25 mmol/L), which intervention is most important for the nurse to implement? Reference Range lonized Calcium [Adult 4.6 to 5.1 mg/dL (1.15 to 1.35 mmol/L)]

Correct Answer is A

Explanation

Correct Answer is B

Explanation

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