An older adult patient with frequent premature ventricular ...

[tfester]

An older adult patient with frequent premature ventricular contractions (PVCs) is receiving intravenous (IV) lidocaine (Xylocaine) by continuous infusion. The patient becomes confused and sees insects on the walls.
 
  What is the nurse's best action? a. Reorient the patient to person, place, and time.
  b. Ask the patient's family about alcohol use or abuse.
  c. Check the patient's chart for a history of dementia.
  d. Notify the prescriber immediately.

Question 2

A patient asks the nurse why an intravenous (IV) line must be used to receive the antidysrhyth-mic drug lidocaine (Xylocaine). What is the nurse's best response?
 
  a. The drug companies have not developed an oral form of this drug.
  b. This drug can also be given by endotracheal tube in the ICU.
  c. The drug in oral form would be destroyed by the liver making it ineffective.
  d. This drug does not work when given by any other route.

[Juro]

Answer to Question 1

D
With older adults, signs of confusion may indicate lidocaine toxicity. Older adults are more sen-sitive to the effects and side effects of this drug. Notify the prescriber immediately; the drug must be stopped and the patient started on another antidysrhythmic drug to prevent life-threatening dysrhythmias such as ventricular tachycardia. Once the drug is discontinued and metabolized, these symptoms will resolve.

Answer to Question 2

C
Lidocaine can only be given by IV or by airway inhalation (ET tube). When given orally, the liver destroys most of the drug, making it ineffective.

[tfester]

TY

[Juro]

You're welcome