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 B

Explanation

Choice A Reason:

Documenting that the nasogastric tube is in the correct place is not appropriate in this scenario. A gastric pH of 7.35 is too high for stomach contents, which typically have a pH between 1.5 and 3.5. This high pH suggests that the tube may be misplaced, possibly in the respiratory tract or another non-gastric location. Therefore, documenting the tube as correctly placed could lead to serious complications if the tube is indeed misplaced.

Choice B Reason:

Notifying the health care provider is the most appropriate action. A pH of 7.35 is indicative of a potential misplacement of the nasogastric tube. The health care provider needs to be informed immediately to take corrective actions, such as ordering an X-ray to confirm the tube’s placement or re-evaluating the tube’s position. This step is crucial to ensure patient safety and prevent complications such as aspiration pneumonia or other adverse effects.

Choice C Reason:

Checking for placement by auscultating for air injected into the tube is an outdated and unreliable method. This technique can sometimes give false assurance of correct placement, as the sound of air can be heard even if the tube is in the respiratory tract. Current best practices recommend using pH testing and radiographic confirmation for accurate placement verification.

Choice D Reason:

Retesting the pH using another strip might seem like a reasonable step, but it is not the best immediate action. If the initial pH test shows a value of 7.35, it is unlikely that retesting will yield a significantly different result. The priority should be to notify the health care provider to address the potential misplacement promptly.

A. Elevate the head of the client’s bed B. Contact the Rapid Response Team C. Tell the client to report vision changes D. Insert a peripheral IV E. Initiate seizure precautions

Correct Answer is B

Explanation

Choice A reason:

Elevating the head of the client’s bed can help reduce blood pressure slightly by promoting venous return and decreasing intracranial pressure. However, this action alone is not sufficient to address the severe hypertension (254/139 mm Hg) the client is experiencing. Immediate medical intervention is required to prevent complications such as stroke, heart attack, or organ damage.

Choice B reason:

Contacting the Rapid Response Team is the highest priority action. The Rapid Response Team is trained to handle critical situations and can provide immediate interventions to stabilize the client’s condition. Severe hypertension at this level requires urgent medical attention to prevent life-threatening complications. The team can administer medications to lower blood pressure quickly and monitor the client closely.

Choice C reason:

Telling the client to report vision changes is important because vision changes can indicate hypertensive retinopathy or increased intracranial pressure. However, this action is not the immediate priority. The client’s blood pressure needs to be controlled urgently to prevent further complications.

Choice D reason:

Inserting a peripheral IV is necessary for administering medications and fluids. While this is an important step, it should follow the immediate action of contacting the Rapid Response Team. The team can then use the IV access to administer antihypertensive medications promptly.

Choice E reason:

Initiating seizure precautions is important because severe hypertension can lead to seizures. However, this action is not the first priority. The primary focus should be on stabilizing the client’s blood pressure through immediate medical intervention.

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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)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing for correct placement of a nasogastric tube. The nurse aspirates the stomach contents, checks the gastric pH, and notes a pH of 7.35. Based on this information, which action should the nurse take at this time?

Correct Answer is B

Explanation

You are caring for a client in the ED with B/P 254/139 mm Hg. Which of the following actions would you take first?

Correct Answer is B

Explanation

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