The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

QT interval

Heart rate

Respiratory rate

Heart rhythm

Urine output

Answer and Explanation

Correct Answer : A,B,D

Choice A Reason:

Monitoring the QT interval is crucial when administering amiodarone because this drug can prolong the QT interval, increasing the risk of torsades de pointes, a potentially life-threatening form of ventricular tachycardia. The QT interval represents the time it takes for the heart’s ventricles to depolarize and repolarize, and prolongation can lead to arrhythmias. Regular monitoring helps in early detection and prevention of such adverse effects.

Choice B Reason:

Heart rate monitoring is essential when administering amiodarone because the drug can cause bradycardia (a slower than normal heart rate). Amiodarone affects the electrical conduction system of the heart, which can lead to significant changes in heart rate. Monitoring the heart rate ensures that any bradycardia is detected early and managed appropriately to prevent complications such as hypotension or heart failure.

Choice C Reason:

While respiratory rate monitoring is important in general patient care, it is not specifically necessary for monitoring the effects of amiodarone. Amiodarone primarily affects the heart’s electrical activity and has less direct impact on respiratory function. However, in cases of severe adverse reactions, such as pulmonary toxicity, respiratory monitoring may become relevant.

Choice D Reason:

Monitoring heart rhythm is vital when administering amiodarone because the drug is used to treat arrhythmias and can also cause new arrhythmias or exacerbate existing ones. Continuous ECG monitoring helps in detecting any abnormal heart rhythms early, allowing for timely intervention. This is particularly important in patients with a history of arrhythmias or those receiving high doses of amiodarone.

Choice E Reason:

Urine output monitoring is not specifically necessary for patients receiving amiodarone. While maintaining adequate urine output is important for overall patient health, amiodarone does not typically affect renal function directly. Therefore, urine output monitoring is not a primary concern when administering this medication.

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Correct Answer is A

Explanation

Choice A Reason:

Continuing to monitor is the most appropriate action in this scenario. The patient has a regular heart rhythm and a heart rate of 60 beats per minute, which is within the normal range for sinus bradycardia. The PR interval is 0.20 seconds, which is at the upper limit of normal. The patient’s vital signs are stable, with a blood pressure of 118/68 mm Hg, a respiratory rate of 16 breaths per minute, and a temperature of 98.8°F (37°C). There are no signs of hemodynamic instability or symptoms that would necessitate immediate intervention. Therefore, ongoing monitoring is sufficient to ensure the patient’s condition remains stable.

Choice B Reason:

Administering clonidine is not appropriate in this situation. Clonidine is an antihypertensive medication that can lower blood pressure and heart rate. Given that the patient’s blood pressure and heart rate are within normal ranges, administering clonidine could potentially cause hypotension and bradycardia, leading to adverse effects. Therefore, clonidine is not indicated for this patient.

Choice C Reason:

Administering atropine is not necessary for this patient. Atropine is used to treat symptomatic bradycardia, where the heart rate is abnormally slow and causing symptoms such as dizziness, hypotension, or syncope. In this case, the patient’s heart rate is 60 beats per minute, which is within the normal range for sinus bradycardia, and there are no symptoms indicating the need for atropine. Therefore, atropine is not required.

Choice D Reason:

Administering digoxin is also not appropriate. Digoxin is a cardiac glycoside used to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It can slow the heart rate and increase the force of cardiac contractions. In this scenario, the patient does not have any indications for digoxin therapy, such as heart failure or atrial fibrillation, and their heart rate is already within the normal range. Therefore, digoxin is not indicated.

A. Administer 0.45% NS at 50 mL/h. B. Obtain daily weight. C. Maintain seizure precautions. D. Administer 3% saline as ordered. E. Encourage fluid intake.

Correct Answer is ["B","C","D"]

Explanation

Choice A Reason:

Administering 0.45% NS (normal saline) at 50 mL/h is not appropriate for a client with SIADH (Syndrome of Inappropriate Antidiuretic Hormone Secretion). This solution is hypotonic and can exacerbate the condition by increasing water retention and worsening hyponatremia. Therefore, this choice is not included in the plan of care.

Choice B Reason:

Obtaining daily weight is crucial for monitoring fluid balance in clients with SIADH. Daily weights help detect fluid retention or loss, which is essential for managing the condition. Accurate weight measurements can indicate changes in fluid status and guide adjustments in treatment.

Choice C Reason:

Maintaining seizure precautions is vital for clients with SIADH because severe hyponatremia can lead to neurological symptoms, including seizures. Implementing seizure precautions helps ensure the client’s safety and allows for prompt intervention if seizures occur.

Choice D Reason:

Administering 3% saline as ordered is appropriate for treating severe hyponatremia in clients with SIADH. Hypertonic saline helps increase serum sodium levels, which is critical for correcting the electrolyte imbalance. This intervention should be closely monitored to avoid rapid changes in sodium levels.

Choice E Reason:

Encouraging fluid intake is not appropriate for clients with SIADH. The condition is characterized by excessive water retention, and increasing fluid intake can worsen hyponatremia. Instead, fluid restriction is typically recommended to manage the condition effectively.

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The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

The nurse is planning care for a client diagnosed with SIADH. Which of the following would be included in the plan of care? Select all that apply.

Correct Answer is ["B","C","D"]

Explanation

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