The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

QT interval

Heart rate

Respiratory rate

Heart rhythm

Urine output

Answer and Explanation

Correct Answer : A,B,D

Choice A Reason:

Monitoring the QT interval is crucial when administering amiodarone because this drug can prolong the QT interval, increasing the risk of torsades de pointes, a potentially life-threatening form of ventricular tachycardia. The QT interval represents the time it takes for the heart’s ventricles to depolarize and repolarize, and prolongation can lead to arrhythmias. Regular monitoring helps in early detection and prevention of such adverse effects.

Choice B Reason:

Heart rate monitoring is essential when administering amiodarone because the drug can cause bradycardia (a slower than normal heart rate). Amiodarone affects the electrical conduction system of the heart, which can lead to significant changes in heart rate. Monitoring the heart rate ensures that any bradycardia is detected early and managed appropriately to prevent complications such as hypotension or heart failure.

Choice C Reason:

While respiratory rate monitoring is important in general patient care, it is not specifically necessary for monitoring the effects of amiodarone. Amiodarone primarily affects the heart’s electrical activity and has less direct impact on respiratory function. However, in cases of severe adverse reactions, such as pulmonary toxicity, respiratory monitoring may become relevant.

Choice D Reason:

Monitoring heart rhythm is vital when administering amiodarone because the drug is used to treat arrhythmias and can also cause new arrhythmias or exacerbate existing ones. Continuous ECG monitoring helps in detecting any abnormal heart rhythms early, allowing for timely intervention. This is particularly important in patients with a history of arrhythmias or those receiving high doses of amiodarone.

Choice E Reason:

Urine output monitoring is not specifically necessary for patients receiving amiodarone. While maintaining adequate urine output is important for overall patient health, amiodarone does not typically affect renal function directly. Therefore, urine output monitoring is not a primary concern when administering this medication.

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Correct Answer is ["A","B","C"]

Explanation

Choice A: Observe for clear drainage.

Reason: Observing for clear drainage is important as it can indicate cerebrospinal fluid (CSF) leakage, especially after nasal or sinus surgery. CSF leakage is a serious complication that requires immediate medical attention. Clear drainage from the nose should be tested for the presence of glucose, which can confirm if it is CSF.

Choice B: Assess for signs of bleeding.

Reason: Assessing for signs of bleeding is crucial in the immediate postoperative period. Nasal packing can sometimes mask ongoing bleeding, so it is important to monitor for any signs of excessive blood loss. This includes checking for blood-soaked dressings, frequent swallowing (which can indicate blood trickling down the throat), and changes in vital signs such as increased heart rate and decreased blood pressure.

Choice C: Watch the client for frequent swallowing.

Reason: Watching the client for frequent swallowing is important because it can be a sign of posterior nasal bleeding. Blood can trickle down the back of the throat, causing the client to swallow frequently. This is a subtle but significant sign that should prompt further investigation and possible intervention.

Choice D: Change the nasal packing.

Reason: This choice is incorrect. Nasal packing should not be changed by the nurse without specific orders from the physician. Changing the packing prematurely can disrupt the surgical site, cause bleeding, and increase the risk of infection. The packing is usually removed by the surgeon or under their direct supervision.

Choice E: Administer a nasal steroid to decrease edema.

Reason: Administering a nasal steroid can help reduce inflammation and edema in the nasal passages. However, this should only be done if prescribed by the physician. Nasal steroids can help improve breathing and reduce discomfort, but they must be used according to medical guidance to avoid potential side effects.

A. Tachycardia B. Hypotension C. Tachypnea D. Fever

Correct Answer is B

Explanation

Choice A: Tachycardia

Tachycardia, defined as a heart rate exceeding 100 beats per minute, can affect the accuracy of pulse oximetry readings. When the heart beats too quickly, it may not fill with enough blood between beats, leading to reduced perfusion and oxygen delivery to tissues. However, while tachycardia can influence the readings, it is not the most significant factor compared to hypotension.

Choice B: Hypotension

Hypotension, or low blood pressure, significantly impacts pulse oximetry accuracy. When blood pressure is low, there is reduced perfusion to peripheral tissues, including the extremities where pulse oximeters are typically placed. This reduced perfusion can lead to inaccurate readings, as the device may not detect sufficient blood flow to measure oxygen saturation accurately. Hypotension is a critical factor that can alter pulse oximetry values, making it the most relevant choice.

Choice C: Tachypnea

Tachypnea, or rapid breathing, can affect oxygen levels in the blood but does not directly interfere with the pulse oximeter’s ability to measure oxygen saturation. While it indicates respiratory distress and can lead to hypoxemia, the pulse oximeter can still provide accurate readings unless accompanied by other factors like low perfusion.

Choice D: Fever

Fever can cause peripheral vasodilation, which might theoretically affect pulse oximetry readings by altering blood flow to the extremities. However, this effect is generally minimal compared to the impact of hypotension. Fever alone is unlikely to cause significant inaccuracies in pulse oximetry measurements.

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The nurse administers amiodarone to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? (Select all that apply)

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Correct Answer is ["A","B","C"]

Explanation

Correct Answer is B

Explanation

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