After an MI, a patient presents with an increasing frequency of ...

[TFauchery]

After an MI, a patient presents with an increasing frequency of PVCs
 
  The patient's heart rate is 110 beats/min, and ECG indicates a sinus rhythm with up to five unifocal PVCs per minute. Which of the following should be done? The patient is alert and responsive and denies any chest pain or dyspnea.
 
  a. Administer lidocaine 100 mg bolus IV push stat.
  b. Administer Cardizem 20 mg IV push stat.
  c. Notify the physician and monitor the patient closely.
  d. Nothing; PVCs are expected in this patient.

Question 2

A patient with bronchogenic oat cell carcinoma has a drop in urine output. The laboratory reports a serum sodium level of 120 mEq/L, a serum osmolality level of 220 mOsm/kg, and urine specific gravity of 1.035. The nurse would suspect
 
  a. diuresis.
  b. DI.
  c. SIADH.
  d. hyperaldosteronism.

[nathang24]

Answer to Question 1

C
Although premature ventricular contractions (PVCs) are frequently present after myocardial infarction, they are not always benign. In individuals with underlying heart disease, PVCs or episodes of self-terminating ventricular tachycardia (VT) are potentially malignant. Nonsustained VT is defined as three or more consecutive premature ventricular beats at a rate faster than 110 beats/min lasting less than 30 seconds. The patient does not appear symptomatic from the PVCs at this time; therefore, lidocaine is not indicated. Cardizem is not prescribed for ventricular ectopy.

Answer to Question 2

C
A decreased urine output, hyponatremia, hypoosmolality, and high urine specific gravity are classic signs of SIADH. Oat cell carcinoma is a precipitating factor for SIADH