A client presents to the emergency healthcare setting and diagnosed with a life-threatening ventricular dysrhythmia. Which of the following medications would the nurse begin to prepare?
Atenolol
Lisinopril
Adenosine
Procainamide
The Correct Answer is D
A) Atenolol: This is a beta-blocker that can be used for various cardiac conditions, including hypertension and certain arrhythmias, but it is not typically the first-line treatment for acute life-threatening ventricular dysrhythmias in the emergency setting.
B) Lisinopril: This medication is an ACE inhibitor primarily used to manage hypertension and heart failure. It does not address acute ventricular dysrhythmias and would not be appropriate for immediate use in this scenario.
C) Adenosine: While adenosine is effective for certain types of supraventricular tachycardia, it is not indicated for life-threatening ventricular dysrhythmias. It has a very short duration of action and is not the drug of choice in this context.
D) Procainamide: This antiarrhythmic medication is specifically used to treat life-threatening ventricular dysrhythmias. It works by stabilizing the cardiac membrane and is indicated in emergency situations to manage these types of arrhythmias. Therefore, preparing procainamide is the most appropriate action for the nurse in this scenario.
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Correct Answer is A
Explanation
A) Gallstones: Gemfibrozil is associated with an increased risk of gallstones. This medication can alter the metabolism of lipids and bile, potentially leading to the formation of gallstones. Clients should be monitored for symptoms such as abdominal pain or discomfort that could indicate gallbladder issues.
B) Decreased PT time: Gemfibrozil does not typically affect prothrombin time (PT). Instead, it may interact with anticoagulants and potentially increase PT time, requiring careful monitoring in patients taking both medications.
C) Hyperkalemia: While hyperkalemia can occur with certain lipid-lowering medications, it is not a common side effect associated with gemfibrozil. This drug primarily affects triglycerides and cholesterol levels without significantly impacting potassium levels.
D) Increased creatinine clearance: Gemfibrozil is not known to increase creatinine clearance; in fact, it can sometimes affect renal function. Monitoring kidney function is important, but increased creatinine clearance is not an expected outcome with this medication.
Correct Answer is A
Explanation
A) Heparin induced thrombocytopenia (HIT): Argatroban is an indirect thrombin inhibitor specifically used for anticoagulation in patients with HIT. This condition involves a significant drop in platelet counts due to heparin therapy, and argatroban is an appropriate alternative for preventing thrombosis in these patients.
B) Ventricular Dysfunction: While managing anticoagulation may be important in patients with ventricular dysfunction, this condition does not specifically necessitate the use of argatroban. Other anticoagulants may be used based on the clinical situation.
C) Myocardial infarction: Although anticoagulation may be warranted in the setting of a myocardial infarction, argatroban is not specifically indicated for this condition. Other antithrombotic therapies, such as aspirin or heparin, are more commonly used.
D) Hepatotoxicity: Argatroban is metabolized in the liver, so caution is warranted in patients with liver dysfunction. Hepatotoxicity itself would not be a reason to use argatroban; rather, it may require close monitoring or adjustment of dosage.