A client is prescribed oral amiodarone for recurrent ventricular dysrhythmias. The nurse should teach the client to notify the physician if which symptom develops?

Edema of ankles

Shortness of breath

Fatigue after exercise

Abdominal fullness

Answer and Explanation

The Correct Answer is B

A. Edema of ankles: While peripheral edema may be associated with worsening cardiac function or side effects from other medications, it is not a hallmark adverse effect of amiodarone. It warrants evaluation but is not the most urgent symptom related to this drug.

B. Shortness of breath: Amiodarone is a potent antiarrhythmic medication with several potential serious side effects, including pulmonary toxicity. This can manifest as interstitial pneumonitis or pulmonary fibrosis, which may present as new or worsening shortness of breath cough, and chest pain. This is a potentially life-threatening complication and requires immediate medical attention.

C. Fatigue after exercise: Exercise-induced fatigue can result from many conditions, including heart disease or deconditioning, but it is a nonspecific symptom. It does not point directly to a serious adverse reaction from amiodarone.

D. Abdominal fullness: Abdominal fullness is not typically associated with amiodarone. It may relate to gastrointestinal or hepatic issues, but it is not as immediately concerning as respiratory symptoms suggestive of pulmonary toxicity.

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Correct Answer is C

Explanation

A. gabapentin & acetaminophen: While acetaminophen may help with pain relief, gabapentin is primarily used for neuropathic pain and not effective for the inflammatory chest pain associated with pericarditis. These medications do not address the positional nature of pericardial pain.

B. extended release opioids: Opioids may provide general pain relief but are not the standard treatment for pericarditis-related pain. They do not address the inflammatory cause and carry risks of sedation and respiratory depression without improving cardiac inflammation.

C. sitting & leaning forward: Pericarditis pain is classically relieved by having the patient sit up and lean forward. This position reduces pressure on the pericardium and decreases pain by allowing the inflamed pericardial layers to separate slightly, reducing friction.

D. supine with head of bed 15 degrees: Lying flat or even slightly elevated can worsen pericarditis pain because it increases pressure on the inflamed pericardium. Patients often report increased discomfort in the supine position, making it less favorable for symptom relief.

A. Dopamine and 50% non-rebreather mask B. Nesiritide IV infusion and digoxin PO C. Diazepam IV push and metoprolol IV D. Morphine IV and oxygen 2 liters via nasal cannula

Correct Answer is D

Explanation

A. Dopamine and 50% non-rebreather mask: Dopamine is a vasopressor used in hypotension or shock, an inotropic agent used to improve cardiac output, not typically first-line for anxiety or respiratory distress. A non-rebreather mask may provide high oxygen levels but can be overwhelming and exacerbate anxiety if not well tolerated.

B. Nesiritide IV infusion and digoxin PO: Nesiritide is a vasodilator which may reduce preload and afterload in heart failure, and digoxin is a positive inotrope that can improve contractility, but neither offers rapid relief for anxiety and dyspnea. These medications have slower onset and are not used primarily for symptom control in acute distress.

C. Diazepam IV push and metoprolol IV: While diazepam may reduce anxiety, it can depress respiration, which is dangerous in decompensated heart failure with potential pulmonary edema. Metoprolol reduces heart rate and contractility and must be used cautiously in acute settings.

D. Morphine IV and oxygen 2 liters via nasal cannula: Morphine reduces preload, anxiety, and the sensation of breathlessness, making it ideal in acute decompensated heart failure. Low-flow oxygen improves oxygenation without overwhelming the patient. This combination directly targets both physiologic and psychological distress.

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A client is prescribed oral amiodarone for recurrent ventricular dysrhythmias. The nurse should teach the client to notify the physician if which symptom develops?

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Naxlex Comprehensive Predictor Exams

The nurse understands that chest pain related to pericarditis is classically relieved by

Correct Answer is C

Explanation

The nurse is caring for a client diagnosed with acute decompensated heart failure. The client is increasingly anxious and restless. The nurse should plan to implement which prescribed orders to assist in relieving these symptoms?

Correct Answer is D

Explanation

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