The nurse is caring for a client with severe left ventricular dysfunction who has been identified as being at risk for sudden cardiac death. What medical intervention can be performed that may extend the survival of the client?
Administration of a calcium channel blocker
Insertion of an implantable cardioverter defibrillator (ICD)
Administration of a beta-blocker
Insertion of an implantable pacemaker
The Correct Answer is B
A. Administration of a calcium channel blocker: Calcium channel blockers are primarily used to manage hypertension, angina, or certain arrhythmias. They do not prevent sudden cardiac death in clients with severe left ventricular dysfunction and have not been shown to improve survival in this population.
B. Insertion of an implantable cardioverter defibrillator (ICD): An ICD continuously monitors the heart rhythm and delivers an electrical shock to terminate life-threatening ventricular arrhythmias, such as ventricular tachycardia or ventricular fibrillation. This intervention significantly reduces the risk of sudden cardiac death and improve long-term survival in clients with severe left ventricular dysfunction.
C. Administration of a beta-blocker: Beta-blockers improve survival in heart failure and reduce the incidence of arrhythmias, but they do not provide immediate protection against sudden cardiac death in high-risk patients as effectively as an ICD.
D. Insertion of an implantable pacemaker: A pacemaker regulates bradyarrhythmias and maintains adequate heart rate but does not terminate life-threatening ventricular tachyarrhythmias. It does not have the same protective effect against sudden cardiac death as an ICD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Restrict fluids: The client’s hemodynamics indicate low blood pressure and low systemic vascular resistance, suggesting distributive shock rather than fluid overload. Fluid restriction would worsen hypotension and further compromise perfusion, making it inappropriate in this scenario.
B. Administer norepinephrine bitartrate: Norepinephrine is a potent vasoconstrictor that increases systemic vascular resistance and blood pressure, improving perfusion in septic shock. Given the client’s low SVR and hypotension despite adequate cardiac output, norepinephrine is the first-line vasoactive agent to restore hemodynamic stability.
C. Administer sodium nitroprusside: Nitroprusside is a vasodilator that decreases SVR and is used for hypertensive emergencies. In this client with septic shock and already low SVR, it would exacerbate hypotension and worsen perfusion, making it contraindicated.
D. Administer lidocaine: Lidocaine is an antiarrhythmic used for ventricular arrhythmias. There is no indication of arrhythmia in this client’s hemodynamic data, so lidocaine would not address the primary problem of hypotension due to low SVR.
Correct Answer is D
Explanation
A. The apical pulse rate is 68 beats/minute: While propranolol lowers heart rate by blocking beta-adrenergic receptors, heart rate alone does not directly indicate prevention of variceal bleeding. The primary goal of therapy is to reduce portal hypertension and prevent hemorrhage.
B. Blood pressure is less than 120/80 mmHg: A reduction in blood pressure can occur with propranolol, but systemic blood pressure is not the most direct measure of efficacy in preventing esophageal variceal bleeding. Portal venous pressure reduction is the key therapeutic target.
C. Capillary refill is less than 2 seconds: Capillary refill reflects peripheral perfusion and is not related to the effectiveness of propranolol in controlling portal hypertension or preventing variceal hemorrhage.
D. Stools test negative for occult blood: The absence of occult blood in stools indicates that bleeding from esophageal varices is being prevented. This directly reflects the effectiveness of propranolol in reducing the risk of variceal hemorrhage, which is the primary therapeutic goal.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.