A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?
STAT administration of atropine
administration of activated charcoal
hemodialysis
intravenous administration of pseudoephedrine
The Correct Answer is A
A) STAT administration of atropine:
This is the correct answer. Atropine is a cholinergic antagonist that can increase heart rate by blocking the action of acetylcholine on cardiac muscarinic receptors. In cases of severe bradycardia, especially if associated with symptoms such as dizziness, syncope, or hypotension, atropine is often administered to increase heart rate and improve cardiac output. The dose of atropine and frequency of administration depend on the severity of bradycardia and the clinical response.
B) Administration of activated charcoal:
Activated charcoal is used in cases of overdose or poisoning to absorb ingested toxins and prevent their absorption into the bloodstream. However, in this scenario, where the primary concern is bradycardia resulting from cholinesterase inhibitor (donepezil) toxicity, activated charcoal would not be effective in reversing the bradycardic effects of the medication.
C) Hemodialysis:
Hemodialysis is a renal replacement therapy used to remove toxins and waste products from the blood in individuals with kidney failure. While hemodialysis may be indicated in cases of severe drug overdose or poisoning to enhance toxin elimination, it is not typically used as a first-line intervention for bradycardia associated with cholinesterase inhibitor toxicity.
D) Intravenous administration of pseudoephedrine:
Pseudoephedrine is a sympathomimetic drug that acts as a vasoconstrictor and can increase heart rate and blood pressure. While it may be used to treat bradycardia in some cases, such as severe symptomatic bradycardia unresponsive to atropine, it is not the first-line treatment for cholinesterase inhibitor toxicity-induced bradycardia. Atropine is preferred due to its direct antagonism of muscarinic receptors in the heart.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Orthostatic hypotension is indicated by a decrease in diastolic blood pressure of 5 mm Hg:
Orthostatic hypotension is typically defined by a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up. Diastolic blood pressure alone is not the primary indicator of orthostatic hypotension.
B) Orthostatic hypotension is indicated by a decrease in systolic blood pressure of 5 mm Hg:
While a decrease in systolic blood pressure is a component of orthostatic hypotension, the criterion for diagnosing orthostatic hypotension is a decrease in systolic blood pressure of 20 mm Hg or more or a decrease in diastolic blood pressure of 10 mm Hg or more within three minutes of standing up.
C) Orthostatic hypotension increases a client's risk of a fall:
This statement is correct. Orthostatic hypotension, characterized by a sudden drop in blood pressure upon standing, can lead to dizziness and lightheadedness, increasing the risk of falls, particularly in older adults.
D) Orthostatic hypotension increases a client's risk of a pulmonary emboli:
Orthostatic hypotension is not directly associated with an increased risk of pulmonary emboli. Pulmonary embolism is a separate condition involving a blockage in the pulmonary artery or its branches, typically caused by a blood clot."
Correct Answer is ["125"]
Explanation
Here's the breakdown of the calculation:
Total volume of fluid to infuse (mL): 1000 mL
Infusion time (hours): 8 hours
Flow rate (mL/hr) = Total volume (mL) / Infusion time (hours)
Flow rate (mL/hr) = 1000 mL / 8 hours = 125 mL/hr (round to nearest whole number as requested)
Therefore, the nurse should program the pump to deliver 125 mL/hr.
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