A client is receiving an initial dose of penicillin IV. During the infusion, the client becomes short of breath. What is the first thing the nurse should do?

Increase the head of the bed.

Place the patient in a recovery position.

Stop the infusion of the medication.

Slow down the infusion of the medication.

Answer and Explanation

The Correct Answer is C

A. Increasing the head of the bed may help ease breathing but does not address the potential cause of the problem.
B. The recovery position is used for unconscious patients to maintain an open airway—not appropriate here.
C. Stopping the infusion of the medication is the first and most critical action. The client is likely experiencing an allergic reaction or anaphylaxis to penicillin, and continuing the drug could worsen symptoms.
D. Slowing the infusion does not prevent further reaction and delays stopping the exposure to the allergen.

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Correct Answer is []

Explanation

Potential Condition: Atrial Fibrillation
The client presents with an irregular, tachycardic rhythm with unclear P waves, which are classic signs of atrial fibrillation (AF). Symptoms such as palpitations, dizziness, and shortness of breath are common with AF, particularly with a rapid ventricular response.

Actions to Take
• Administer an anticoagulant: AF increases the risk of thrombus formation in the atria, which can lead to embolic stroke. Anticoagulation reduces this risk, especially in symptomatic or persistent cases.
• Obtain a 12-lead ECG: This helps confirm the diagnosis, assess the rhythm in detail, and rule out other arrhythmias or ischemic changes that may be present.

Parameters to Monitor
• Manifestations of stroke: Clients with AF are at increased risk for embolic stroke. Neurological status should be closely monitored for signs of confusion, facial droop, weakness, or speech changes.
• PTT/INR: These lab values help assess coagulation status, particularly when anticoagulants such as warfarin or heparin are initiated, to ensure therapeutic levels and avoid bleeding complications.

A. Ongoing cardiac care by a health care provider is unnecessary after valvuloplasty B. Lifelong anticoagulant therapy is needed after mechanical valve replacement C. Biologic replacement valves require the use of immunosuppressive drugs D. Mechanical mitral valves require replacement approximately every 5-years

Correct Answer is B

Explanation

A. Ongoing cardiac care is still necessary after valvuloplasty to monitor valve function and complications.
B. Mechanical valve replacements require lifelong anticoagulant therapy to prevent thromboembolism, which is an important consideration when comparing with valvuloplasty.
C. Biologic valves do not require immunosuppressive drugs because they are derived from animal tissue.
D. Mechanical valves are durable and often last longer than 5 years, usually 10-20 years or more before replacement might be needed.

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A client is receiving an initial dose of penicillin IV. During the infusion, the client becomes short of breath. What is the first thing the nurse should do?

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Correct Answer is []

Explanation

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