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 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.
Correct Answer is C
Explanation
The client's presentation of chest pain radiating to the left arm, sweating, shortness of breath, epigastric discomfort, cool and diaphoretic skin, tachycardia, and ST elevation on the electrocardiogram (ECG) are indicative of myocardial infarction (heart attack). These symptoms and findings are typical of acute coronary syndrome, specifically an ST-segment elevation myocardial infarction (STEMI).
Option A (Ischemic Stroke) is not the correct answer because the symptoms described in the client's presentation are primarily related to the cardiovascular system and not indicative of an ischemic stroke.
Option B (Chronic Stable Angina) is not the correct answer because chronic stable angina typically presents with chest pain on exertion or stress, and it usually subsides with rest or nitroglycerin. The client's symptoms of chest pain at rest, along with other findings, are more concerning for an acute cardiac event like a myocardial infarction.
Option D (Cardiogenic Shock) is a severe complication that can occur following a myocardial infarction, but the information provided in the scenario does not suggest that the client is in cardiogenic shock at this time. The client's blood pressure is not mentioned in the scenario, which is a crucial parameter to assess for cardiogenic shock.
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