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 C

Explanation

A) "I should limit my fluid intake while taking this medication":
This statement is incorrect. Furosemide is a loop diuretic that increases urine production to reduce fluid overload in conditions like heart failure or edema. It is essential for clients taking furosemide to maintain adequate hydration to prevent dehydration. Therefore, the client should not limit their fluid intake while taking this medication.

B) "My blood pressure will increase while I am taking this medication":
This statement is incorrect. Furosemide is primarily used to reduce blood pressure by promoting diuresis and reducing fluid volume. Therefore, it is unlikely that blood pressure would increase while taking this medication.

C) "I should take this medication in the morning rather than at night":
This is the correct answer. Furosemide is usually taken in the morning to prevent nocturia (excessive urination at night), as it can increase urinary frequency. Taking it earlier in the day allows for better fluid balance during waking hours and reduces the need to wake up frequently during the night to urinate.

D) "I should eat a diet low in potassium while taking this medication":
This statement is incorrect. Furosemide can cause potassium depletion as a side effect, so clients may be advised to consume potassium-rich foods or supplements unless contraindicated due to other medical conditions. However, it is not necessary to eat a diet low in potassium while taking furosemide unless specifically instructed by a healthcare provider.

A. Hypoxemia B. Apnea C. Pleural effusion D. Dysphagia

Correct Answer is A

Explanation

A) Hypoxemia:
This is the correct answer. Atelectasis, which is the collapse or incomplete inflation of the lung, can lead to impaired gas exchange and subsequent hypoxemia. As lung volume decreases due to collapse, ventilation-perfusion (V/Q) mismatch occurs, resulting in decreased oxygenation of arterial blood. Hypoxemia is a common finding in individuals with atelectasis and may manifest as decreased oxygen saturation levels on pulse oximetry or arterial blood gas analysis.

B) Apnea:
Apnea, defined as the cessation of breathing, is not typically associated with atelectasis. While atelectasis can contribute to respiratory compromise and may result in respiratory distress, including tachypnea or increased work of breathing, it does not usually lead to complete cessation of breathing.

C) Pleural effusion:
A pleural effusion is the accumulation of fluid in the pleural space surrounding the lungs. While pleural effusion may occur concurrently with atelectasis, it is not an expected finding specifically associated with atelectasis itself. Pleural effusion may cause respiratory symptoms such as dyspnea or chest pain but is not a primary manifestation of atelectasis.

D) Dysphagia:
Dysphagia, or difficulty swallowing, is unrelated to atelectasis. While dysphagia can occur as a result of various conditions affecting the esophagus or neurological control of swallowing, it is not a typical manifestation of atelectasis. Atelectasis primarily affects the lungs and respiratory function rather than swallowing function.

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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

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Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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