After the nurse gives IV atropine to a patient with symptomatic type 1. second-degree atrioventricular (AV) block, which finding indicates that the drug has been effective?
Increase in the patient's heart rate.
Decrease in premature ventricular contractions.
Increase in strength of peripheral pulses.
Decrease in premature atrial contractions
The Correct Answer is A
Atropine is an anticholinergic medication that acts by blocking the effects of the parasympathetic nervous system on the heart, leading to an increase in heart rate (positive chronotropic effect) and conduction velocity (positive dromotropic effect). In patients with symptomatic type 1 second degree atrioventricular (AV) block (also known as Mobitz type 1 or Wenckebach), the electrical impulses between the atria and ventricles are delayed or blocked intermittently, resulting in a progressive lengthening of the PR interval until a ventricular beat is dropped.
When atropine is administered to a patient with symptomatic type 1 AV block, it can counteract the increased vagal tone that contributes to the block and help improve the conduction through the AV node. As a result, the heart rate is expected to increase, which is a positive response to the medication.
The other options listed (B) Decrease in premature ventricular contractions, (C) Increase in strength of peripheral pulses, and (D) Decrease in premature atrial contractions, are not directly related to the effect of atropine on type 1 AV block and are not typical findings associated with atropine administration in this context. The main goal of administering atropine in this situation is to increase the heart rate and improve the AV conduction to alleviate symptoms associated with the AV block.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Diuretics are the primary class of drugs used to treat volume overload in patients with acute decompensated heart failure (ADHF). These medications help to increase urine output, reducing the overall fluid volume in the body and relieving congestion in the lungs and other tissues.
The goal of using diuretics in ADHF is to alleviate symptoms such as shortness of breath, edema (swelling), and fluid retention by promoting the elimination of excess fluid. The most commonly used diuretics in this setting are loop diuretics (e.g., furosemide, bumetanide), which have a potent diuretic effect and can rapidly reduce fluid overload.
While narcotics, vasodilators, and positive inotropes may have roles in specific cases of ADHF, they are not the primary drugs used to treat volume overload. Narcotics may be used for pain management, vasodilators to reduce afterload (the resistance the heart has to pump against), and positive inotropes to increase the heart's contractility in certain situations. However, the first-line treatment for volume overload in ADHF is diuretic therapy.
Correct Answer is A
Explanation
In a patient with acute decompensated heart failure (ADHF), the priority nursing assessment is to auscultate lung sounds. ADHF is characterized by the sudden worsening of heart failure symptoms, which may include pulmonary congestion and fluid accumulation in the lungs. Assessing lung sounds helps to identify signs of pulmonary edema, which is a serious complication of ADHF.
The nurse should listen for crackles or rales, which are abnormal lung sounds caused by the presence of fluid in the alveoli. These findings suggest that the patient is experiencing fluid overload and inadequate gas exchange in the lungs. Prompt recognition of pulmonary edema allows for early intervention, such as administering diuretics or other medications, to relieve fluid overload and improve respiratory function.
While the other options (B) Facial swelling, (C) Level of anxiety, and (D) Intake and output, are important assessments in a patient with heart failure, they are not the priority in a patient with manifestations of acute decompensated heart failure. The priority is to assess for signs of respiratory
distress and pulmonary congestion, as these can quickly lead to respiratory failure and life threatening complications.
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