Which of the following medications does the nurse identify as a calcium channel blocker used to treat tachycardia and manage heart rate?
Digoxin
Diltiazem (Cardizem)
Nitroglycerin
Nitroprusside (Nipride)
The Correct Answer is B
Choice A rationale:
Digoxin is a cardiac glycoside, not a calcium channel blocker. It works by increasing the force of contraction of the heart muscle and slowing the heart rate. However, it is not typically used as a first-line treatment for tachycardia. It's more commonly used to treat heart failure and atrial fibrillation.
Mechanism of action: Digoxin inhibits the sodium-potassium ATPase pump in cardiac cells, leading to an increase in intracellular calcium. This increased calcium availability enhances myocardial contractility. Digoxin also indirectly affects the autonomic nervous system, leading to a decrease in heart rate.
Key points:
Digoxin is not a calcium channel blocker.
It's used primarily for heart failure and atrial fibrillation.
Its mechanism of action involves increasing intracellular calcium and decreasing heart rate.
Choice B rationale:
Diltiazem (Cardizem) is a calcium channel blocker that is commonly used to treat tachycardia and manage heart rate. It works by blocking the movement of calcium into cardiac cells, which slows down the electrical conduction system of the heart and leads to a decrease in heart rate.
Mechanism of action: Diltiazem blocks L-type calcium channels in cardiac and vascular smooth muscle cells. This reduces calcium influx, leading to:
Decreased myocardial contractility Vasodilation (relaxation of blood vessels)
Negative chronotropic effect (decreased heart rate)
Negative dromotropic effect (slowed conduction through the AV node) Key points:
Diltiazem is a calcium channel blocker.
It's effective in treating tachycardia and managing heart rate.
Its mechanism of action involves blocking calcium channels, leading to various cardiovascular effects.
Choice C rationale:
Nitroglycerin is a vasodilator, not a calcium channel blocker. It works by relaxing the smooth muscle in blood vessels, which widens the vessels and allows more blood to flow through them. This can help to relieve chest pain (angina) and lower blood pressure, but it does not directly affect heart rate.
Mechanism of action: Nitroglycerin is metabolized to nitric oxide, which activates guanylate cyclase, leading to increased production of cyclic guanosine monophosphate (cGMP). cGMP causes smooth muscle relaxation, resulting in vasodilation.
Key points:
Nitroglycerin is a vasodilator, not a calcium channel blocker. It's primarily used for angina and hypertension.
Its mechanism of action involves nitric oxide-mediated vasodilation.
Choice D rationale:
Nitroprusside (Nipride) is a potent vasodilator, not a calcium channel blocker. It is typically used in critical care settings to manage severe hypertension or heart failure. It works by relaxing the smooth muscle in blood vessels, which widens the vessels and allows more blood to flow through them. This can help to lower blood pressure, but it does not directly affect heart rate.
Mechanism of action: Nitroprusside directly releases nitric oxide, leading to vasodilation. Key points:
Nitroprusside is a potent vasodilator, not a calcium channel blocker.
It's used in critical care settings for severe hypertension or heart failure.
Its mechanism of action involves direct nitric oxide release and vasodilation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Fever is not a common side effect of metformin. While it's possible for a minority of patients to experience a mild fever as their bodies adjust to the medication, it's not considered a typical or expected adverse effect.
Fevers typically occur due to infections or inflammation, and metformin does not directly cause either of these processes.
If a patient taking metformin develops a fever, it's crucial to rule out other potential causes, such as infections or other medications, before attributing it to metformin.
Choice B rationale:
Insomnia is also not a common side effect of metformin. In fact, some studies have suggested that metformin may even have a positive effect on sleep quality in some individuals.
While sleep disturbances can occur with any medication, they are not specifically associated with metformin.
If a patient experiences insomnia while taking metformin, it's essential to consider other potential factors, such as stress, anxiety, or other medications, that could be contributing to sleep problems.
Choice C rationale:
Bitter or metallic taste is a very common side effect of metformin, experienced by approximately 30-40% of patients. This taste disturbance is thought to be caused by metformin's interaction with taste receptors on the tongue.
The taste is often described as metallic, bitter, or similar to the taste of pennies.
While it can be unpleasant, it's generally not considered a serious side effect and does not usually require discontinuation of the medication.
Some strategies to manage the metallic taste include: Taking metformin with meals or snacks to mask the taste.
Chewing sugar-free gum or sucking on hard candy after taking the medication. Rinsing the mouth with water or mouthwash after taking the medication.
Switching to an extended-release formulation of metformin, which may have a less pronounced metallic taste.
Choice D rationale:
Seizures are a rare but serious side effect of metformin.
They are most likely to occur in patients with underlying kidney problems or those taking certain other medications that can interact with metformin.
If a patient taking metformin experiences a seizure, it's critical to seek immediate medical attention.
Correct Answer is B
Explanation
Choice A rationale:
It is not recommended to take levothyroxine with food as it can interfere with its absorption.
Food, particularly those containing calcium or iron, can bind to levothyroxine in the gastrointestinal tract, reducing the amount of medication that is absorbed into the bloodstream.
This can lead to decreased effectiveness of the medication.
It's generally advised to take levothyroxine on an empty stomach, at least 30-60 minutes before breakfast, to ensure optimal absorption.
Choice B rationale:
Taking levothyroxine first thing in the morning, on an empty stomach, is the most effective way to ensure its absorption and consistent hormone levels throughout the day.
This aligns with the body's natural rhythm of thyroid hormone production, which typically peaks in the morning hours.
Taking the medication consistently at the same time each day helps maintain stable thyroid hormone levels, which is crucial for managing hypothyroidism effectively.
Choice C rationale:
Relief of symptoms with levothyroxine therapy often takes several weeks, not just one week.
It takes time for the body to adjust to the medication and for thyroid hormone levels to reach a therapeutic range.
Patients should be counseled to have patience and continue taking the medication as prescribed, even if they don't experience immediate symptom relief.
They should also be monitored regularly by their healthcare provider to assess their response to treatment and make any necessary adjustments to the dosage.
Choice D rationale:
Doubling the dose of levothyroxine without consulting a healthcare provider is dangerous and can lead to serious health consequences.
Overdosing on levothyroxine can cause hyperthyroidism, which can manifest as rapid heart rate, anxiety, tremors, weight loss, and other health problems.
It's essential to follow the prescribed dosage and not make any changes without the guidance of a healthcare professional.
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