A patient arrives at the hospital emergency department via EMS, complaining of being “lightheaded”. The patient has a heart rate of 42 and BP 90/50 mmHg.
What medication should the RN anticipate being prescribed and administered immediately?
Adenosine.
Amiodarone.
Magnesium sulfate.
Atropine sulfate.
The Correct Answer is D
Choice A rationale:
Adenosine is a medication used to treat supraventricular tachycardia (SVT), a type of rapid heart rhythm that originates in the upper chambers of the heart. It works by slowing the conduction of electrical impulses through the heart's AV node.
In this patient, the heart rate is already slow (42 beats per minute), so adenosine would not be appropriate. It could further slow the heart rate and potentially cause a dangerous drop in blood pressure.
Choice B rationale:
Amiodarone is a medication used to treat a variety of heart rhythm problems, including ventricular tachycardia (VT) and ventricular fibrillation (VF). It works by slowing the conduction of electrical impulses through the heart muscle.
Amiodarone is not typically used as a first-line treatment for bradycardia (slow heart rate). It is usually reserved for more serious or life-threatening arrhythmias.
Choice C rationale:
Magnesium sulfate is a medication used to treat a variety of conditions, including preeclampsia, eclampsia, and torsades de pointes. It can also be used to treat certain types of arrhythmias.
Magnesium sulfate is not typically used as a first-line treatment for bradycardia. It may be used in some cases of bradycardia caused by electrolyte imbalances or certain medications.
Choice D rationale:
Atropine sulfate is a medication that blocks the action of acetylcholine, a neurotransmitter that slows the heart rate. It is the first-line treatment for symptomatic bradycardia.
Atropine works by increasing the heart rate and improving conduction through the AV node. It is a rapid-acting medication that can be given intravenously, intramuscularly, or subcutaneously.
In this patient, atropine sulfate would be the most appropriate medication to increase the heart rate and improve blood pressure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale:
Hypoglycemia is the most frequent side effect of insulin administration. It occurs when blood glucose levels drop too low, typically below 70 mg/dL.
Insulin is a hormone that plays a key role in regulating blood glucose levels. It works by promoting the uptake of glucose from the bloodstream into cells, where it can be used for energy.
When too much insulin is administered, or when blood glucose levels are already low, it can lead to hypoglycemia. Symptoms of hypoglycemia can vary, but they often include:
Shakiness Sweating Anxiety Hunger Palpitations Confusion Dizziness Blurred vision Seizures
Loss of consciousness
If hypoglycemia is not treated promptly, it can lead to serious complications, such as coma or death.
Therefore, it is important to be aware of the signs and symptoms of hypoglycemia and to take steps to prevent it. This may involve monitoring blood glucose levels regularly, adjusting insulin doses as needed, and carrying a source of fast-acting glucose, such as glucose tablets or juice, to treat hypoglycemia if it occurs.
Correct Answer is C
Explanation
Rationale for Choice A:
Decreasing the morning insulin dose by half without consulting the provider could lead to hyperglycemia, which can be dangerous for patients with diabetes, especially those undergoing surgery.
It is important to individualize insulin doses based on the patient's blood glucose levels, insulin sensitivity, and other factors. The provider may need to assess the patient's blood glucose levels and adjust the insulin dose accordingly.
Rationale for Choice B:
It is not safe to assume that the provider would want the client to receive the usual insulin dose prior to surgery without confirming this with the provider.
Patients with diabetes who are NPO (nothing by mouth) are at risk for hypoglycemia, as they are not receiving their usual intake of carbohydrates.
It is important to adjust insulin doses to prevent hypoglycemia in these patients.
Rationale for Choice D:
Holding the morning dose of insulin until after a fasting glucose is done could lead to hyperglycemia, as the patient would not be receiving any insulin to cover their blood glucose levels.
It is important to administer insulin to patients with diabetes, even if they are NPO, to prevent hyperglycemia.
Rationale for Choice C:
This is the best action for the nurse to take because it ensures that the provider is aware of the situation and can provide appropriate orders for the patient's insulin management.
The provider may need to adjust the insulin dose, order a fasting glucose level, or provide other instructions for the patient's care.
It is important to communicate with the provider to ensure that the patient receives safe and appropriate care.
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