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 ["B","C","E"]
Explanation
A) Is it caused by demyelination of the nerve fibers:
Myasthenia gravis is not primarily caused by demyelination of nerve fibers. It is characterized by dysfunction at the neuromuscular junction, specifically involving the acetylcholine receptors.
B) Is it thought to be an autoimmune disease:
This is correct. Myasthenia gravis is considered an autoimmune disorder in which the body's immune system mistakenly targets and attacks its own tissues, particularly the acetylcholine receptors at the neuromuscular junction.
C) It is associated with destruction of acetylcholine receptor sites:
This is correct. In myasthenia gravis, there is a reduction in the number of functional acetylcholine receptors due to autoimmune-mediated destruction or blocking of these receptors.
D) Once symptoms present, it has a 5-year survival rate:
This statement is inaccurate. Myasthenia gravis is a chronic condition, but survival rates are not determined by the onset of symptoms. With appropriate treatment, many individuals with myasthenia gravis can manage their symptoms effectively and have a normal life expectancy.
E) It is a chronic and progressive muscular disease:
This is correct. Myasthenia gravis is a chronic neuromuscular disorder characterized by fluctuating muscle weakness and fatigue. While it is chronic, it is not necessarily progressive in all cases, as symptoms may stabilize or improve with treatment.
F) Is it best treated with antibiotics:
Antibiotics are not the primary treatment for myasthenia gravis. Treatment typically involves medications that enhance neuromuscular transmission, such as acetylcholinesterase inhibitors or immunosuppressive drugs, along with other supportive measures.
Correct Answer is A
Explanation
A) "Take the medication with a full glass of water":
This is the correct answer. Docusate is a stool softener used to treat constipation by promoting the incorporation of water into the stool, making it softer and easier to pass. Taking docusate with a full glass of water helps facilitate its action by ensuring hydration and aiding in the softening of stool.
B) "Take this medication on an empty stomach":
Taking docusate on an empty stomach is not necessary. It can be taken with or without food. The primary consideration is to take it with an adequate amount of water to facilitate its stool-softening effect.
C) "Do not take this medication before bedtime":
There is no specific contraindication to taking docusate before bedtime. The timing of administration can vary based on individual preferences and bowel habits. Some individuals may prefer to take it before bedtime to promote a bowel movement in the morning, while others may take it at different times of the day.
D) "Expect abdominal pain with this medication":
Abdominal pain is an uncommon side effect of docusate. While it may occur in some individuals, it is not a common or expected reaction to the medication. Most people tolerate docusate well, but gastrointestinal side effects such as mild abdominal cramping, nausea, or diarrhea may occur in some cases.
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