A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate ie 116/ min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?
Administer amiodarone IV
Start Carotid massage
Administer Tylenol
Assess patient LOC
The Correct Answer is D
D. Assessing the patient's level of consciousness (LOC) is essential to determine their neurological status and assess for any signs of deterioration. Changes in LOC could indicate worsening sepsis, hypoperfusion, or other underlying issues that require immediate attention.
A. Administering amiodarone, an antiarrhythmic medication, is not the first action to take in this situation. While amiodarone may be used to manage certain arrhythmias, its use should be based on a thorough assessment and specific arrhythmia diagnosis. In this case, with only three seconds of PVCs followed by sinus tachycardia, immediate administration of amiodarone is not warranted.
B. Carotid massage is not indicated in this scenario. Carotid massage is typically used to slow down or terminate supraventricular tachycardias (SVTs), such as paroxysmal supraventricular tachycardia (PSVT). However, it is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), carotid artery disease, or recent myocardial infarction (MI). Furthermore, PVCs are not typically responsive to carotid massage.
C. Administering Tylenol (acetaminophen) may be appropriate in this situation. The patient's elevated temperature (101.1°F) suggests the presence of fever, which could contribute to the patient's tachycardia. Lowering the fever with acetaminophen may help reduce the heart rate and alleviate symptoms associated with fever, such as discomfort.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
B This maneuver, called the Valsalva maneuver, can sometimes help to restore normal heart rhythm in cases of SVT. It involves blowing forcefully into a syringe or performing a similar action that increases intra-abdominal pressure, which can stimulate the vagus nerve and help to slow down the heart rate.

A Defibrillation is a treatment used for life-threatening cardiac arrhythmias, particularly ventricular fibrillation or pulseless ventricular tachycardia. It involves delivering a therapeutic dose of electrical energy to the heart with a device called a defibrillator.
C Drawing troponin levels may be appropriate if there is suspicion of myocardial infarction as the cause of chest palpitations or if there are other symptoms suggestive of acute coronary syndrome. However, in the context of SVT presenting with chest palpitations and a racing heart, the priority is to address the arrhythmia first
D Amiodarone is an antiarrhythmic medication used to treat various types of cardiac arrhythmias, including ventricular and supraventricular arrhythmias. While it can be effective in certain cases of SVT, it is not typically the first-line treatment or the immediate next step in managing SVT in the emergency department.
Correct Answer is B
Explanation
B Metformin is an oral antidiabetic medication commonly used to treat type 2 diabetes. There is a potential risk of lactic acidosis when metformin is used in conjunction with contrast material, particularly in patients with underlying renal impairment. Contrast-induced nephropathy can exacerbate renal dysfunction, leading to increased levels of metformin and potentially increasing the risk of lactic acidosis. Therefore, metformin use before or after contrast administration should be carefully monitored, and in some cases, temporarily discontinued to reduce the risk of lactic acidosis.
A Atorvastatin is a statin medication commonly used to lower cholesterol levels. It does not have a direct interaction with contrast material used in cardiac catheterization. Therefore, it does not place the client at risk for acute kidney injury related to contrast-induced nephropathy (CIN).
C Carvedilol is a beta-blocker medication used to treat high blood pressure and heart failure. It does not have a direct interaction with contrast material used in cardiac catheterization. Therefore, it does not place the client at risk for acute kidney injury related to contrast-induced nephropathy (CIN).
D Nitroglycerin is a medication commonly used to relieve chest pain (angina) in patients with coronary artery disease. It does not have a direct interaction with contrast material used in cardiac catheterization. Therefore, it does not place the client at risk for acute kidney injury related to contrast- induced nephropathy (CIN).
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