A nurse is caring for a client in the ICU. The client's ECG monitor tracing reveals sinus bradycardia and S-T segment elevation. The client reports shortness of breath and feeling dizzy and faint. Which of the following medications should the nurse administer?
Lidocaine
Digoxin
Atropine
Sotalol
The Correct Answer is C
C. Atropine is an anticholinergic medication that increases heart rate by blocking vagal tone to the heart. It is used to treat symptomatic bradycardia, including sinus bradycardia that causes hemodynamic instability
A Lidocaine is primarily used for the treatment of ventricular arrhythmias, particularly in the setting of acute myocardial infarction or during cardiac arrest. Sinus bradycardia with S-T segment elevation suggests ischemia or injury to the heart muscle (myocardium) rather than ventricular arrhythmias.
B. Digoxin is a medication used to increase myocardial contractility and reduce heart rate in certain heart conditions such as atrial fibrillation or heart failure. It is not typically indicated for acute management of sinus bradycardia
D. Sotalol is a beta-blocker with class III antiarrhythmic properties. It is used primarily for the management of atrial and ventricular arrhythmias, not for acute coronary syndrome or sinus bradycardia with myocardial ischemia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
A. This is a serious complication in DKA, particularly in children, where the shift in osmolality during treatment can lead to fluid shifts into the brain. It can present with neurological deterioration, headache, altered mental status, and even coma.
B. Septic shock
While infection can precipitate DKA, septic shock itself is not a direct complication of DKA. However, DKA can predispose patients to infections due to impaired immune function, dehydration, and hyperglycemia.
C. Cardiac arrhythmias
Electrolyte imbalances, particularly hypokalemia or hyperkalemia (depending on treatment phase), can predispose individuals with DKA to cardiac arrhythmias such as ventricular arrhythmias (e.g., ventricular tachycardia) or atrial fibrillation.
D. Renal failure
Acute kidney injury (AKI) can occur due to dehydration, electrolyte imbalances, and the direct effects of acidosis. However, with prompt and appropriate treatment, renal function typically recovers.
E. Hypotension
Dehydration and volume depletion are common in DKA due to osmotic diuresis and fluid loss. This can lead to hypovolemic shock and hypotension if not adequately managed with fluid resuscitation.
F Respiratory alkalosis
DKA is associated with metabolic acidosis, not respiratory alkalosis. The body compensates for acidosis by increasing respiratory rate (Kussmaul respirations) to blow off CO2 and normalize pH, but this does not lead to respiratory alkalosis.
Correct Answer is B
Explanation
B. Laryngeal edema, or swelling of the larynx (voice box), is a hallmark feature of severe anaphylaxis. It can lead to airway obstruction and respiratory distress, which are critical components of an anaphylactic reaction.
A Arrhythmias (abnormal heart rhythms) can occur as a result of various causes, including medications, but they are not specific to anaphylaxis. They may or may not be present during an anaphylactic reaction.
C. Hypertension (high blood pressure) is not a typical feature of anaphylaxis. Instead, hypotension (low blood pressure) is more commonly associated with anaphylactic shock, which is a severe form of anaphylaxis.
D. Fever is not typically associated with anaphylaxis. Anaphylactic reactions typically involve rapid onset of symptoms such as flushing, hives, swelling, respiratory distress, and potentially cardiovascular collapse, but not fever.
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