Medical surgical Nursing Cases and Answers

Medical surgical Nursing Cases and Answers Adenosine - CORRECT ANSWER-- *antiarrhythmic agent*; depresses conduction at AV node - first line of drug for most forms of PSVT to convert rhythm to NSR - does NOT convert a-fib, a-flutter, or v-tach - Nursing Implications: short half-life (< 10 sec) - Dangerous drug: can cause transient side effects - flushing, chest pain or tightness, brief periods of asytole or bradycardia - Initial bolus given rapidly over 1-3 seconds followed by a normal saline bolus of 20 ml Alpha-Beta Blockers - CORRECT ANSWER-- blocks alpha receptors causing vasodilation (↓ BP, ↓SVR) - blocks beta receptors decreasing HR and contractility (↓HR) - Nursing Implications: monitor for bradycardia and hypotension; also do not give to pts w/out pacemaker - Carvedilol is 3-5x more potent in ↓BP than some BB; use w/caution Amiodarone - CORRECT ANSWER-- *Potassium channel blocker*; used to treat acute suppression of refractory ventricular tachycardia and v-fib - "because of potentially life-threatening side effects, it should only be prescribed for lifethreatening recurrent v-fib and unstable v-tach" - adverse effects: multiple complex drug interactions