A nurse provides teaching for a patient who will begin taking ...

[APUS57]

A nurse provides teaching for a patient who will begin taking procainamide (Procanbid) for long-term suppression of a dysrhythmia. Which statement by the patient indicates a need for further teaching?
 
  a. I need to take this drug at evenly spaced intervals around the clock.
  b. I may have increased bruising, but this is a temporary side effect.
  c. I should report pain and swelling in my joints when taking this drug.
  d. I will need to have blood tests at regular intervals while taking this drug.

Question 2

A patient with atrial fibrillation is taking verapamil (Calan). The patient has read about the drug on the Internet and wants to know why a drug that affects the rate of ventricular contraction is used to treat an abnormal atrial contraction.
 
  What will the nurse tell the patient?
  a. Drugs that treat ventricular dysrhythmias help to restore normal sinus rhythm.
  b. Atrial dysrhythmias can have life-threatening effects on ventricular function.
  c. Treating ventricular dysrhythmias helps prevent the likelihood of stroke.
  d. When ventricular contraction slows, atrial contraction is also slowed.

[hollysheppard095]

Answer to Question 1

ANS: B
Blood dyscrasias are a rare but potentially fatal side effect of procainamide and are an indication for withdrawing the drug. Procainamide should be taken around the clock at evenly spaced intervals. Lupuslike symptoms may occur; inflammation of the joints is one manifestation and should be reported so that antinuclear antibody (ANA) titers can be monitored. Because of the risk of lupuslike symptoms and blood dyscrasias, blood tests need to be done weekly at first and then periodically thereafter.

Answer to Question 2

ANS: B
Dysrhythmic activity in the atria does not significantly reduce cardiac output but can be dangerous when dysrhythmic impulses cross the AV node, causing ventricular dysrhythmias, which can be life threatening. Treating ventricular dysrhythmia helps improve ventricular pumping. These drugs do not restore normal sinus rhythm. To prevent stroke, an anticoagulant, such as warfarin, is used. Slowing ventricular contraction does not affect the rate of atrial contraction. Restoring normal sinus rhythm requires cardioversion, short-term treatment with amiodarone or sotalol, or RF ablation of the dysrhythmia source.

[APUS57]

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