A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?

Permanent pacemakers

Emergency cardioversion

IV adenosine (Adenocard)

Anticoagulant therapy

Answer and Explanation

The Correct Answer is D

When a patient with dilated cardiomyopathy develops new onset atrial fibrillation (AF) that has been unresponsive to drug therapy, the nurse should prioritize patient education about anticoagulant therapy. Atrial fibrillation increases the risk of blood clots forming in the heart's atria due to the irregular and ineffective pumping of blood. These blood clots can potentially travel to other parts of the body, leading to serious complications such as stroke.

Anticoagulant therapy, also known as blood-thinning medication, is commonly prescribed for patients with atrial fibrillation to prevent the formation of blood clots. The most common anticoagulant prescribed for AF is warfarin or direct oral anticoagulants (DOACs) such as apixaban, rivaroxaban, dabigatran, or edoxaban. The nurse should educate the patient about the importance of taking the anticoagulant as prescribed and the need for regular monitoring of clotting times (INR for warfarin) to ensure the medication is effective and the dose is appropriate.

While other options listed in the choices may be relevant in specific situations, the priority in this case is to address the potential risk of stroke associated with atrial fibrillation and the importance of anticoagulant therapy to manage that risk effectively.

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Correct Answer is C

Explanation

Pericarditis is inflammation of the pericardium, the sac-like membrane surrounding the heart. It can cause chest pain, which is often worsened by deep breathing or coughing. The goal of treatment for pericarditis is to reduce inflammation and relieve pain.

In this case, the client's pain level is reported as 6 out of 10. As per the PRN (as-needed) medication options given:

C) Oral ibuprofen (Motrin) 600 mg: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) and can help reduce inflammation and relieve pain in cases of pericarditis. It is an appropriate choice for this client's pain level of 6 out of 10.

A) IV morphine sulfate 4 mg: IV morphine is a potent opioid analgesic and may be appropriate for severe pain. However, in this case, the client's pain level is moderate (6 out of 10), and it is not the first-line medication for pericarditis pain.

B) Oral acetaminophen (Tylenol) 650 mg: Acetaminophen is a mild analgesic and antipyretic that can be effective for mild to moderate pain. However, in this situation, the client's pain is moderate (6 out of 10), and acetaminophen alone may not provide adequate relief for pericarditis pain.

D) Fentanyl 1 mg IV: Fentanyl is another potent opioid analgesic. However, similar to morphine, it may be more appropriate for severe pain, not moderate pain like in this scenario.

Based on the client's pain level and the goal of reducing inflammation, the most appropriate PRN medication for the nurse to give is oral ibuprofen (Motrin) 600 mg.

A. Hypokalemia B. Hyponatremia C. Hypercalcemia D. Hyperphosphatemia

Correct Answer is D

Explanation

A patient with chronic kidney disease is at risk for hyperphosphatemia. In chronic kidney disease, the kidneys' ability to excrete phosphate is impaired, leading to elevated levels of phosphate in the blood. This can further lead to calcium-phosphate imbalances, bone problems, and other complications associated with kidney disease. Managing phosphate levels is an essential aspect of the treatment plan for patients with chronic kidney disease.

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A patient with dilated cardiomyopathy has new onset atrial fibrillation that has been unresponsive to drug therapy for several days. What topic should the nurse plan to include in patient teaching?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is C

Explanation

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Correct Answer is D

Explanation

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