The primary care NP refers a patient to a cardiologist who ...

[APUS57]

The primary care NP refers a patient to a cardiologist who diagnoses long QT syndrome. The cardiologist has prescribed propranolol (Inderal). The patient exercises regularly and is not obese.
 
  The patient asks the NP what else can be done to minimize risk of sudden cardiac arrest. The NP should counsel the patient to: a. drink extra fluids when exercising.
  b. reduce stress with yoga and hot baths.
  c. ask the cardiologist about an implantable defibrillator.
  d. ask the cardiologist about adding procainamide to the drug regimen.

Question 2

A patient who is taking trimethoprim-sulfamethoxazole for prophylaxis of urinary tract infections tells the primary care NP that a sibling recently died from a sudden cardiac arrest, determined to be from long QT syndrome. The NP should:
 
  a. schedule a treadmill stress test.
  b. order genetic testing for this patient.
  c. discontinue the trimethoprim-sulfamethoxazole.
  d. refer the patient to a cardiologist for further evaluation.

[dreamfighter72]

Answer to Question 1

A
Patients with long QT syndrome should avoid situations in which they might overheat or get dehydrated. This patient should be encouraged to drink plenty of fluids while exercising and should avoid activities such as yoga and hot baths. Implantable cardioverter-defibrillators are used for high-risk patients. Procainamide can cause long QT syndrome.

Answer to Question 2

B
When a family member's death is found to be from long QT syndrome, the entire family must undergo testing. Treadmill testing may be normal in many cases. Trimethoprim-sulfamethoxazole can prolong the QT interval and should not be used in patients at risk, but genetic testing should be performed to determine this.

[APUS57]

Both answers were spot on, thank you once again

[dreamfighter72]

Great! Please up vote