The nurse is preparing to administer procainamide (Pronestyl) ...

[amal]

The nurse is preparing to administer procainamide (Pronestyl) intravenously for conversion of atrial flutter. How should the nurse position the client?
 
  1. In Trendelenburg position
  2. Prone
  3. Supine
  4. With the head of the bed elevated

Question 2

A client is started on sotalol (Betapace) for conversion of atrial fibrillation. Which finding requires immediate nursing action?
 
  1. A widening of the QRS complex
  2. Complaints of a flutter feeling in the chest
  3. Complaints of headache
  4. Increased blood glucose level

[amandalm]

Answer to Question 1

Correct Answer: 3
Rationale 1: The Trendelenburg position would be used in the event of a hypotensive episode.
Rationale 2: The prone position is not used because it inhibits access to the airway.
Rationale 3: The supine position should be maintained with IV infusion of Pronestyl due to the increased risk of hypotension.
Rationale 4: The head of the bed should not be elevated due to risk of hypotension with IV infusion of Pronestyl.
Global Rationale: The supine position should be maintained with IV infusion of Pronestyl due to the increased risk of hypotension. The Trendelenburg position would be used in the event of a hypotensive episode. The prone position is not used because it inhibits access to the airway. The head of the bed should not be elevated due to risk of hypotension with IV infusion of Pronestyl.

Answer to Question 2

Correct Answer: 1
Rationale 1: Sotalol delays repolarization and prolongs the refractory period, thus widening the QT interval. Widening of the QRS complex can be a precursor to ventricular tachycardia. The health care provider should be alerted immediately, and the medication held.
Rationale 2: Complaints of a flutter feeling in the chest are characteristic of atrial fibrillation, for which the client is receiving treatment.
Rationale 3: There is no indication that treatment with sotalol induces headache as an adverse effect.
Rationale 4: There is no evidence that sotalol increases blood glucose levels.
Global Rationale: Sotalol delays repolarization and prolongs the refractory period, thus widening the QT interval. Widening of the QRS complex can be a precursor to ventricular tachycardia. The health care provider should be alerted immediately, and the medication held. Complaints of a flutter feeling in the chest are characteristic of atrial fibrillation, for which the client is receiving treatment. There is no indication that treatment with sotalol induces headache or increased blood glucose levels as an adverse effect.

[amal]

TYSM

[Alyson.hiatt@yahoo.com]

Thanks for the timely response, appreciate it