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A patient with heart failure is prescribed sotalol for atrial fibrillation. Which of the following should the nurse recognize as a potential concern?

A.

Increases the force of the heart's contractions (Positive Inotropic Effect)

B.

Hypertension

C.

Decreases the force of the heart's contractions (Negative Inotropic Effect)

D.

Hypercholesterolemia

Answer and Explanation

The Correct Answer is C

(A) Positive Inotropic Effect: Sotalol does not increase contractility; it weakens contractions, making it a negative inotrope.

(B) Hypertension: Sotalol primarily lowers blood pressure and heart rate, which can actually cause hypotension.

(C) Negative Inotropic Effect: Sotalol is a beta-blocker that decreases myocardial contractility, which can further reduce cardiac output in heart failure patients.

(D) Hypercholesterolemia: Sotalol does not significantly impact cholesterol levels.


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Related Questions

Correct Answer is A

Explanation

(A) Hyponatremia: SIADH leads to excess ADH secretion, causing water retention, dilution of sodium levels, and hyponatremia.

(B) Hypokalemia: SIADH does not primarily affect potassium.

(C) Hypernatremia: Excess ADH dilutes sodium, leading to low sodium levels, not high.

(D) Hyperkalemia: SIADH primarily causes hyponatremia, not potassium imbalances.

Correct Answer is C

Explanation

(A) 0.45% NaCl (Hypotonic Fluid): Used for mild dehydration but can cause fluid shifts leading to cerebral edema.

(B) 3% NaCl (Hypertonic Fluid): Used for severe hyponatremia, not dehydration.

(C) Lactated Ringer’s (LR): This isotonic fluid replaces lost fluids and electrolytes, making it the best choice for severe dehydration, especially in patients with electrolyte imbalances.

(D) D5W: Initially isotonic but becomes hypotonic once glucose is metabolized, leading to fluid shifts into cells, worsening dehydration.

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