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 A

Explanation

This is the correct response. ACE inhibitors are known to cause a persistent, dry, and irritating cough in some individuals. This adverse effect occurs due to the accumulation of bradykinin and other substances in the lungs, leading to increased sensitivity of the cough reflex. The cough typically resolves upon discontinuation of the ACE inhibitor.

B) Respiratory depression:
Respiratory depression is not a common side effect of ACE inhibitors. ACE inhibitors do not directly affect respiratory drive or function in the central nervous system. Therefore, this option is incorrect.

C) Spontaneous pneumothorax:
Spontaneous pneumothorax is not a typical adverse effect associated with ACE inhibitor use. ACE inhibitors do not directly cause the development of pneumothorax, which is characterized by the presence of air in the pleural space. Therefore, this option is incorrect.

D) Pneumonia:
While ACE inhibitors can increase the risk of respiratory infections due to their effect on the immune system, pneumonia is not a specific adverse effect associated with ACE inhibitor use. Pneumonia is typically caused by infectious agents such as bacteria, viruses, or fungi, rather than being a direct effect of ACE inhibitors. Therefore, this option is incorrect.”

A. Check the client's perianal skin integrity. B. Educate the patient on which foods the patient should eat. C. Investigate the client's emotional concerns. D. Review the client's electrolyte values.

Correct Answer is D

Explanation

A) Check the client's perianal skin integrity:
Assessing perianal skin integrity is important in the care of a client with ulcerative colitis, particularly due to the potential for diarrhea and irritation. However, this is not the first priority upon admission for an acute exacerbation.

B) Educate the patient on which foods the patient should eat:
Nutritional education is crucial in managing ulcerative colitis, but it is not the priority during the initial assessment and admission for an acute exacerbation. Stabilizing the client's condition and addressing immediate needs take precedence.

C) Investigate the client's emotional concerns:
While emotional support is important, particularly in chronic conditions like ulcerative colitis, assessing emotional concerns is not the first action required upon admission for an acute exacerbation. Physical stabilization and assessment of the client's condition are the initial priorities.

D) Review the client's electrolyte values:
This is the correct answer. During an acute exacerbation of ulcerative colitis, there is a risk of electrolyte imbalance due to diarrhea and fluid loss. Reviewing the client's electrolyte values is crucial to assess the severity of dehydration and electrolyte imbalances, which can have immediate implications for the client's treatment plan and stabilization.

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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

ACE inhibitors work on the RAAS to prevent the conversion of angiotensin I to angiotensin II. Because this blocking occurs in the cells in the lung, which is usually the site of this conversion, the use of ACE inhibitors often results in

Correct Answer is A

Explanation

A nurse is caring for a client who is being admitted for an acute exacerbation of ulcerative colitis. Which of the following actions should the nurse take first?

Correct Answer is D

Explanation

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