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

Answer and Explanation

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.

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Correct Answer is ["675"]

Explanation

1. Convert client weight from pounds to kilograms (kg):

We know 1 kg = 2.205 pounds.

Client weight (kg) = 198 lb / 2.205 lb/kg = 90 kg (round to nearest whole number for this calculation).

2. Calculate the total daily dosage:

Prescribed dosage per kg per day: 15 mg/kg/day

Client weight (kg): 90 kg (rounded value from step 1)

Total daily dosage (mg): Dosage (mg/kg/day) x Client weight (kg)

Total daily dosage (mg): 15 mg/kg/day x 90 kg = 1350 mg/day

3. Since the dosage is divided equally every 12 hours, calculate the amount per dose:

Frequency of administration: Every 12 hours

Total daily dosage (mg): 1350 mg/day

Dosage per dose (mg) = Total daily dosage (mg) / Frequency (doses/day)

Dosage per dose (mg) = 1350 mg/day / 2 doses/day

Dosage per dose (mg) = 675 mg/dose (round to nearest whole number as requested)

Therefore, the nurse should administer approximately 675 mg of vancomycin with each dose.

A. Routinely exercise indoors B. Wear dark, warm clothing during the summer months C. Avoid extremes of temperature on exertion D. Take frequent showers in the evenings and early mornings

Correct Answer is C

Explanation

A) Routinely exercise indoors:
Exercising indoors may be beneficial for individuals taking anticholinergic drugs to minimize the risk of heat-related complications. However, this option does not directly address the need to avoid extremes of temperature on exertion, which is crucial for preventing heat exhaustion and heat stroke. While indoor exercise can provide a controlled environment, it does not eliminate the risk entirely, especially if the indoor area is not adequately ventilated or air-conditioned.

B) Wear dark, warm clothing during the summer months:
Wearing dark, warm clothing during the summer months can exacerbate the risk of heat-related complications for individuals taking anticholinergic drugs. Dark clothing absorbs more heat from the sun, increasing body temperature, and warm clothing further contributes to heat retention. This option does not align with the goal of minimizing the risk of heat exhaustion and heat stroke.

C) Avoid extremes of temperature on exertion:
This is the correct answer. Avoiding extremes of temperature on exertion is essential for individuals taking anticholinergic drugs to reduce the risk of heat-related complications such as heat exhaustion and heat stroke. Exertion in hot environments can lead to excessive sweating and dehydration, further compromising thermoregulation. By avoiding extremes of temperature and moderating exertion, individuals can better regulate body temperature and minimize the risk of heat-related adverse effects.

D) Take frequent showers in the evenings and early mornings:
While taking frequent showers in the evenings and early mornings may help cool the body and reduce the risk of heat-related discomfort, it does not specifically address the need to avoid extremes of temperature on exertion. While personal hygiene practices are important, they should be supplemented with measures aimed at preventing heat-related complications, such as avoiding exertion in extreme temperatures. Therefore, this option does not fully meet the goal of minimizing the risk of heat exhaustion and heat stroke for individuals taking anticholinergic drugs.

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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?

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Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer vancomycin 15 mg/kg/day divided equally every 12 hr. The client weighs 198 lb. How many mg should the nurse administer with each dose? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

Correct Answer is ["675"]

Explanation

A client taking anticholinergic drugs should be taught to minimize the risks of heat exhaustion and heat stroke. What would be one way to meet this goal?

Correct Answer is C

Explanation

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