The nurse is preparing to administer adenosine to a patient with SVT (supraventricular tachycardia). Important considerations before administration include which of the following? (Select all that apply)
Rapid saline flush following administration
Rapid IV push administration
Initial recommended dosage of 12 mg IV bolus
Long half-life of adenosine, which may prolong adverse medication effects
Constant EKG monitoring
Correct Answer : A,B,E
A. Rapid saline flush following administration: Adenosine has an extremely short half-life (less than 10 seconds), so a rapid saline flush immediately after the IV push is essential to ensure the medication reaches the heart quickly. This enhances its effectiveness in terminating SVT by transiently blocking AV nodal conduction.
B. Rapid IV push administration: Adenosine must be administered as a rapid IV bolus, ideally through a proximal vein, to achieve immediate therapeutic effect. Slow administration can reduce its efficacy because the drug is metabolized almost immediately by the vascular endothelium and lungs.
C. Initial recommended dosage of 12 mg IV bolus: The initial recommended dose for adenosine is typically 6 mg IV push, not 12 mg. The dose may be increased to 12 mg if the first dose is ineffective. Administering 12 mg initially is higher than standard protocol and could increase the risk of transient adverse effects.
D. Long half-life of adenosine, which may prolong adverse medication effects: Adenosine actually has a very short half-life (less than 10 seconds), so adverse effects are brief and self-limiting. It does not have a prolonged effect, making this statement inaccurate.
E. Constant EKG monitoring: Continuous ECG monitoring is critical during adenosine administration because transient asystole or AV block may occur. Monitoring allows the nurse to immediately identify arrhythmia termination or adverse effects, ensuring patient safety throughout the intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. dissolve the clot in the coronary artery and prevent further cellular death: Fibrinolytic therapy, such as alteplase or tenecteplase, is designed to lyse the thrombus occluding the coronary artery. Rapid clot dissolution restores blood flow to ischemic myocardium, limiting the extent of myocardial necrosis and preserving cardiac function, which is critical in acute STEMI management.
B. prevent the development of life-threatening arrhythmias: While restoring coronary perfusion may reduce arrhythmia risk indirectly, fibrinolytic therapy’s primary purpose is thrombus dissolution, not direct arrhythmia prevention. Arrhythmias are managed with antiarrhythmic drugs or supportive interventions.
C. assist ventricular contraction and promote coronary artery perfusion: Fibrinolytics do not directly enhance ventricular contractility. Improved perfusion occurs as a result of reopening the blocked artery rather than stimulating myocardial contraction.
D. prevent the development of further clotting in the coronary arteries: Antiplatelet or anticoagulant therapies are used to prevent new thrombus formation. Fibrinolytic therapy specifically targets existing clots rather than acting as a prophylactic measure against future clotting.
Correct Answer is C
Explanation
A. Nitroglycerine and Viagra should be taken at the same time: Taking nitroglycerine and Viagra together is extremely dangerous. Both drugs cause vasodilation and can lead to severe hypotension, syncope, or even cardiovascular collapse. Patients must be explicitly warned against simultaneous use.
B. Viagra is not effective when used in combination with nitroglycerine: The issue is not the efficacy of Viagra but the risk of life-threatening hypotension when the two medications are combined. Effectiveness of Viagra is not the concern; safety is the priority.
C. Viagra should not be used within 24 hours of taking nitroglycerine: The safest practice is to avoid nitrates for at least 24 hours after taking sildenafil (Viagra) due to the risk of profound hypotension. This instruction directly addresses patient safety and is a critical point for discharge teaching to prevent potentially fatal interactions.
D. The effect of nitroglycerine is impaired by concurrent use of Viagra: Nitroglycerine’s effectiveness is not impaired; instead, the combination potentiates vasodilation, leading to dangerously low blood pressure. The concern is additive hypotensive effects, not reduced efficacy of nitroglycerine.
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