When administering dopamine (Intropin), it is most important for the nurse to know that:
-
Solution
the drug cannot be directly mixed in solutions containing bicarbonate or aminophylline.
The nurse is responsible for knowing compatible solutions before administering dopamine (Intropin). It is important to know that drug action varies by dose, but the physician is responsible for determining the dose. Dopamine should not be used instead of fluid replacement. Choice D is incorrect because, although it is true, it is not the nurse’s primary concern. It is a collaborative action in which the physician is involved in determining the rate.
Norepinephrine (Levophed) is contraindicated in which of the following conditions?
-
Solution
Hypovolemic shock
Norepinephrine (Levophed) is contraindicated in hypovolemia. Neurogenic shock is an indication for norepinephrine use. Norepinephrine is given to maintain a systolic blood pressure of 80-100 mmHG. Decreased renal perfusion is an adverse reaction.
Following norepinephrine (Levophed) administration, it is essential to the nurse to assess:
-
Solution
color and temperature of toes and fingers
Because decreased perfusion is a side effect of norepinephrine (Levophed), the nurse must check circulation frequently. Capillary refill is not a reliable indication of perfusion in a shock state. Choices A and D are not specific for norepinephrine.
Epinephrine is used to treat cardiac arrest and status asthmaticus because of which of the following actions?
-
Solution
Bronchodilation and increased heart rate, contractility, and conduction
Bronchodilation results from stimulated beta receptors, and cardiac effects result from the stimulation of ß1 receptors. Choice A does not address respiratory effects of medication. Choice C is incorrect because α-stimulating drugs cause vasoconstriction. Bronchodilation, not bronchoconstriction, results from ß2 activity.
The most toxic antiarrhythmic agent is:
-
Solution
amiodarone (Cordarone)
This is the most toxic drug and should be used only if other less toxic agents have been tried. Digoxin, on the other hand, is cardiotonic, not antiarrhythmic agent. B and D are not known for their toxicity.
Which of the following drugs should be used only in situations in which the client can be very closely monitored, such as a critical care unit?
-
Solution
bretylium (Bretylol)
Among the choices, this is the only agent that must be monitored this closely. B, C, and D are given to outpatients as oral preparations.
Which of the following blood tests will tell the nurse that an adequate amount of drug is present in the blood to prevent arrhythmias?
-
Solution
Drug levels
Knowing drug levels (peak and trough) is the only way to ensure there is enough drug in the body to work. Other choices do not demonstrate drug effect.
When administering an antiarrhythmic agent, which of the following assessment parameters is the most important for the nurse to evaluate?
-
Solution
ECG
The ECG is the most important parameter to assess. B, C, and D need to be monitored, but the ECG is the most important.
Which of the following ECG findings alerts the nurse that the client needs an antiarrhythmic?
-
Solution
Frequent ventricular ectopy
Ventricular ectopy can be a life-threatening arrhythmia; therefore, the client needs an arrhythmic. Other choices are not arrhythmias that need to be treated.
Which of the following drugs can cause severe hematologic disorders?
-
Solution
procainamide (Pronestyl)
Pronestyl is known for this serious side effect. Associate Pronestyl with plasma — P and P. This drug is known for its hematologic side effects.