NSG 2281 EXAM QUESTIONS WITH COMPLETE
SOLUTIONS
Adenosine Class and Action? Correct Answers Func. class.:
Antidysrhythmic—miscellaneous
Action:
Slows conduction through AV node, can interrupt reentry
pathways through AV node, and can restore normal sinus
rhythm in patients with paroxysmal supraventricular tachycardia
(PSVT), decreases cardiac oxygen demand decreasing hypoxia
Adenosine Nursing Considerations and Patient Education?
Correct Answers Nursing considerations
• Assess cardiopulmonary status: pulse, respiration, ECG
intervals (PR, QRS, QT); check for transient dysrhythmias
(PVCs, PACs, sinus tachycardia, AV block)
• Assess respiratory status: rate, rhythm, lung fields for crackles,
watch for respiratory depression; bilateral crackles may occur in
CHF patient; if increased respiration, increased pulse occurs,
product should be discontinued
Patient/family education
• Tell patient to report facial flushing, dizziness, sweating,
palpitations, chest pain
Adenosine Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Normal sinus rhythm in patients diagnosed with SVT or
diagnosis of perfusion defect
Uses:
PSVT, as a diagnostic aid to assess myocardial perfusion defects
in CAD; Wolff-Parkinson-White (WPW) syndrome
,Amiodarone Class and Action? Correct Answers Func. class.:
Antidysrhythmic (Class III)
Action:
Prolongs action potential duration and effective refractory
period, noncompetitive α- and β-adrenergic inhibition; increases
50PR and QT intervals, decreases sinus rate, decreases
peripheral vascular resistance
Amiodarone Nursing Considerations and Black Box Warning?
Correct Answers BLACK BOX WARNING:
Monitor ECG continuously to determine product effectiveness;
measure PR, QRS, QT intervals; check for PVCs, other
dysrhythmias; monitor B/P continuously for hypo/hypertension;
check for rebound hypertension after 1-2 hr
Assess for pulmonary toxicity including ARDS, pulmonary
fibrosis: dyspnea, fatigue, cough, fever, chest pain; product
should be discontinued if these occur, increased at higher doses,
toxicity is common
Monitor cardiac rate, respiration: rate, rhythm, character, chest
pain, ventricular tachycardia, supraventricular tachycardia or
fibrillation
Amiodarone Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Decreased amount and severity of ventricular dysrhythmias
Uses:
Hemodynamically unstable ventricular tachycardia,
supraventricular tachycardia, ventricular fibrillation not
controlled by 1st-line agents
, Amlodipine Class and Action? Correct Answers Func. class.:
Antianginal, calcium channel blocker, antihypertensive
Action:
Inhibits calcium ion influx across cell membrane during cardiac
depolarization; produces relaxation of coronary vascular smooth
muscle and peripheral vascular smooth muscle; dilates coronary
vascular arteries; increases myocardial oxygen delivery in
patients with vasospastic angina
Amlodipine Nursing Considerations and Patient Education?
Correct Answers Nursing considerations
• Assess fluid volume status: distended red veins, crackles in
lung; color, quality, and specific gravity of urine, skin turgor,
adequacy of pulses, moist mucous membranes, bilateral lung
sounds, peripheral pitting edema; dehydration symptoms of
decreasing output, thirst, hypotension, dry mouth and mucous
membranes should be reported
• Assess for angina: intensity, location, duration of pain
• Monitor B/P and pulse; if B/P drops, call prescriber
Patient/family education
• Advise patient to avoid hazardous activities until stabilized on
product, dizziness is no longer a problem
• Advise to avoid large amounts of grapefruit juice or alcohol
Amlodipine Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Decreased angina pectoris, dysrhythmias, B/P
Uses:
Chronic stable angina pectoris, hypertension; may coadminister
with other antihypertensives, antianginals
SOLUTIONS
Adenosine Class and Action? Correct Answers Func. class.:
Antidysrhythmic—miscellaneous
Action:
Slows conduction through AV node, can interrupt reentry
pathways through AV node, and can restore normal sinus
rhythm in patients with paroxysmal supraventricular tachycardia
(PSVT), decreases cardiac oxygen demand decreasing hypoxia
Adenosine Nursing Considerations and Patient Education?
Correct Answers Nursing considerations
• Assess cardiopulmonary status: pulse, respiration, ECG
intervals (PR, QRS, QT); check for transient dysrhythmias
(PVCs, PACs, sinus tachycardia, AV block)
• Assess respiratory status: rate, rhythm, lung fields for crackles,
watch for respiratory depression; bilateral crackles may occur in
CHF patient; if increased respiration, increased pulse occurs,
product should be discontinued
Patient/family education
• Tell patient to report facial flushing, dizziness, sweating,
palpitations, chest pain
Adenosine Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Normal sinus rhythm in patients diagnosed with SVT or
diagnosis of perfusion defect
Uses:
PSVT, as a diagnostic aid to assess myocardial perfusion defects
in CAD; Wolff-Parkinson-White (WPW) syndrome
,Amiodarone Class and Action? Correct Answers Func. class.:
Antidysrhythmic (Class III)
Action:
Prolongs action potential duration and effective refractory
period, noncompetitive α- and β-adrenergic inhibition; increases
50PR and QT intervals, decreases sinus rate, decreases
peripheral vascular resistance
Amiodarone Nursing Considerations and Black Box Warning?
Correct Answers BLACK BOX WARNING:
Monitor ECG continuously to determine product effectiveness;
measure PR, QRS, QT intervals; check for PVCs, other
dysrhythmias; monitor B/P continuously for hypo/hypertension;
check for rebound hypertension after 1-2 hr
Assess for pulmonary toxicity including ARDS, pulmonary
fibrosis: dyspnea, fatigue, cough, fever, chest pain; product
should be discontinued if these occur, increased at higher doses,
toxicity is common
Monitor cardiac rate, respiration: rate, rhythm, character, chest
pain, ventricular tachycardia, supraventricular tachycardia or
fibrillation
Amiodarone Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Decreased amount and severity of ventricular dysrhythmias
Uses:
Hemodynamically unstable ventricular tachycardia,
supraventricular tachycardia, ventricular fibrillation not
controlled by 1st-line agents
, Amlodipine Class and Action? Correct Answers Func. class.:
Antianginal, calcium channel blocker, antihypertensive
Action:
Inhibits calcium ion influx across cell membrane during cardiac
depolarization; produces relaxation of coronary vascular smooth
muscle and peripheral vascular smooth muscle; dilates coronary
vascular arteries; increases myocardial oxygen delivery in
patients with vasospastic angina
Amlodipine Nursing Considerations and Patient Education?
Correct Answers Nursing considerations
• Assess fluid volume status: distended red veins, crackles in
lung; color, quality, and specific gravity of urine, skin turgor,
adequacy of pulses, moist mucous membranes, bilateral lung
sounds, peripheral pitting edema; dehydration symptoms of
decreasing output, thirst, hypotension, dry mouth and mucous
membranes should be reported
• Assess for angina: intensity, location, duration of pain
• Monitor B/P and pulse; if B/P drops, call prescriber
Patient/family education
• Advise patient to avoid hazardous activities until stabilized on
product, dizziness is no longer a problem
• Advise to avoid large amounts of grapefruit juice or alcohol
Amlodipine Therapeutic Outcome and Uses? Correct Answers
Therapeutic outcome:
Decreased angina pectoris, dysrhythmias, B/P
Uses:
Chronic stable angina pectoris, hypertension; may coadminister
with other antihypertensives, antianginals
