When caring for a patient who has been admitted for his heart failure, the nurse observes that the patient is experiencing bradycardia. Which drug should be administered to patients who develop bradycardia?
Atropine
Cholestyramine
Inamrinone
Milrinone
The Correct Answer is A
A. Atropine is an anticholinergic medication that increases heart rate by blocking vagal effects on the heart, making it the first-line treatment for symptomatic bradycardia.
B. Cholestyramine is a bile acid sequestrant used to lower cholesterol levels and does not have any effects on heart rate.
C. Inamrinone is a phosphodiesterase inhibitor used in heart failure for inotropic support but is not specifically indicated for bradycardia management.
D. Milrinone is also a phosphodiesterase inhibitor used for heart failure but does not address bradycardia directly.
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Correct Answer is A
Explanation
A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.
B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.
C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.
D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.
Correct Answer is B
Explanation
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.