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 A
Explanation
A) Excretion:
This is the correct answer. The kidneys play a crucial role in the excretion of drugs and their metabolites from the body. After drugs undergo metabolism in the liver or other tissues, the resulting metabolites are often water-soluble and can be filtered by the kidneys into the urine. This process helps eliminate drugs and their byproducts from the body, preventing their accumulation and potential toxicity.
B) Absorption:
Absorption refers to the movement of drugs from the site of administration into the bloodstream. While the kidneys do not directly facilitate drug absorption, they may indirectly influence drug absorption by regulating blood flow and systemic circulation.
C) Metabolism:
Metabolism, or biotransformation, involves the enzymatic alteration of drugs into metabolites, which are often more water-soluble and easier to excrete. While the liver is the primary site of drug metabolism, the kidneys do not play a direct role in drug metabolism.
D) Distribution:
Distribution refers to the movement of drugs from the bloodstream to various tissues and organs in the body. While the kidneys do not directly influence drug distribution, changes in renal function can affect drug distribution by altering blood flow and plasma protein binding. However, the primary role of the kidneys in pharmacokinetics is excretion, not distribution.
Correct Answer is A
Explanation
A) The parasympathetic nervous system:
This is the correct answer. The parasympathetic nervous system is responsible for regulating rest and digestion. It controls activities such as increased gastric motility, secretion of digestive enzymes, and relaxation of sphincters in the gastrointestinal tract. Activation of the parasympathetic nervous system promotes digestion and absorption of nutrients by increasing gastrointestinal activity.
B) The limbic system:
The limbic system is primarily involved in emotions, behavior, and long-term memory formation. While emotions can influence gastrointestinal function, including appetite and digestion, the limbic system itself does not directly control gastric motility and digestion.
C) The central nervous system:
The central nervous system includes the brain and spinal cord and plays a vital role in integrating and coordinating all body activities. While it indirectly influences gastrointestinal function through autonomic nervous system control, it is not the primary regulator of gastric motility and digestion.
D) The sympathetic nervous system:
The sympathetic nervous system is responsible for the body's fight or flight response, which involves activities such as increasing heart rate, dilating airways, and redirecting blood flow away from the digestive organs to skeletal muscles during times of stress or arousal. It typically inhibits digestive processes, including gastric motility, to conserve energy for immediate survival needs.
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