A patient is to receive a continuous infusion of Diltiazem at 2.5 mg hr for Atrial fibrillation, The medication is supplied 125 mg of Diltlazem in 125 mL of IV fluid. At what rate should the nurse set the IV pump? (round to the nearest tenth)

Answer and Explanation

The Correct Answer is ["2.5"]

Ordered Dose: The doctor has prescribed Diltiazem at a rate of 2.5 mg per hour. This means the patient needs to receive 2.5 milligrams of Diltiazem every hour.

Medication Concentration: The medication is supplied as 125 mg of Diltiazem in 125 mL of fluid. This translates to a concentration of 1 mg of Diltiazem per 1 mL of solution.

Since the medication concentration is 1 mg/mL, delivering 2.5 mg of Diltiazem per hour requires infusing 2.5 mL of the solution per hour.

Therefore, the nurse should set the IV pump to deliver 2.5 mL/hr of the Diltiazem solution.

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Correct Answer is D

Explanation

A) Maintaining strict bedrest for first 24 hours:
While bedrest is often recommended in the early stages following a myocardial infarction (MI), the priority nursing intervention is to reduce oxygen demand on the heart, which can be achieved through pain management and controlling the workload on the heart, rather than solely relying on bedrest. Bedrest alone may not address the underlying physiological needs of the heart, such as reducing ischemia or controlling pain.

B) Measuring urine output hourly and performing daily weights:
Monitoring urine output and performing daily weights are important in managing fluid balance, especially for those with heart failure or volume overload. However, in the acute phase of an anterior wall myocardial infarction, the priority intervention is addressing the oxygen demand on the heart and providing pain relief, which is more immediate in stabilizing the client and reducing myocardial injury.

C) Keeping the environment quiet to decrease cardiac workload:
While creating a calm and quiet environment helps in reducing stress and decreasing cardiac workload, it is still secondary to actively managing the oxygen demand of the heart. Decreasing the workload of the heart is essential, but this is done more effectively through interventions such as pain management, oxygen therapy, and medications that reduce myocardial oxygen demand (e.g., nitroglycerin, beta-blockers).

D) Reducing oxygen demand and providing pain control:
This is the highest priority intervention for a client who has suffered an acute anterior wall myocardial infarction (MI). Pain from an MI increases the heart's oxygen demand and can exacerbate ischemia. Pain relief, often with morphine, not only reduces pain but also helps in vasodilation, reducing the heart's workload. Additionally, oxygen therapy should be given to ensure adequate oxygenation, and medications like beta-blockers, nitroglycerin, and ACE inhibitors are used to reduce the workload of the heart.

A. Hypertension treated with medications B. Prostate surgery six months prior C. Use of intravenous substances D. Stroke diagnosed one year ago

Correct Answer is C

Explanation

A) Hypertension treated with medications
Hypertension (high blood pressure) itself is not a direct cause of infectious endocarditis. While untreated or poorly managed hypertension can contribute to cardiovascular complications, it is not typically a risk factor for developing infectious endocarditis. Infectious endocarditis is more commonly associated with conditions that directly involve the heart valves or blood stream, such as intravenous drug use, prior heart valve disease, or certain invasive procedures.

B) Prostate surgery six months prior
While certain surgeries, such as dental or urinary tract procedures, can increase the risk of infectious endocarditis due to transient bacteremia, prostate surgery by itself is not a major risk factor for this condition. Unless there was a complication during the surgery that resulted in bacteremia (e.g., infection), B is not the most likely contributor to the development of infectious endocarditis.

C) Use of intravenous substances
The use of intravenous (IV) substances, especially illicit drugs, is a major risk factor for the development of infectious endocarditis. Intravenous drug use, particularly when non-sterile needles or contaminated substances are used, can introduce bacteria directly into the bloodstream, leading to bacteremia.

D) Stroke diagnosed one year ago
While a history of stroke may indicate underlying cardiovascular disease or embolic events, it is not directly related to the development of infectious endocarditis. Stroke can occur as a complication of infectious endocarditis, particularly if emboli from infected valves travel to the brain. However, a prior stroke itself does not directly contribute to the development of endocarditis.

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A patient is to receive a continuous infusion of Diltiazem at 2.5 mg hr for Atrial fibrillation, The medication is supplied 125 mg of Diltlazem in 125 mL of IV fluid. At what rate should the nurse set the IV pump? (round to the nearest tenth)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing intervention is highest priority for the client who has suffered an acute anterior wall mycordial infarction?

Correct Answer is D

Explanation

The nurse is caring for a client with infectious endocarditis. Which information obtained from the health history could have contributed to the development of the disease progress?

Correct Answer is C

Explanation

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