A prescriber has ordered propranolol (Inderal) for a patient with ...

[Yi-Chen]

A prescriber has ordered propranolol (Inderal) for a patient with recurrent ventricular tachycardia. The nurse preparing to administer this drug will be concerned about what in the patient's history?
 
  a. Asthma
  b. Exercise-induced tachyarrhythmias
  c. Hypertension
  d. Paroxysmal atrial tachycardia associated with emotion

Question 2

A nurse is caring for a patient in the intensive care unit who is receiving intravenous lidocaine. The patient is drowsy and confused and reports numbness of the fingers and toes. Which standing order will the nurse initiate at this time?
 
  a. Administer diazepam.
  b. Reduce the rate of infusion.
  c. Discontinue the infusion.
  d. Prepare for mechanical ventilation.

[durant1234]

Answer to Question 1

ANS: A
Propranolol is contraindicated in patients with asthma, because it is a nonselective beta-adrenergic antagonist and can cause bronchoconstriction and exacerbate asthma. It is used to treat tachyarrhythmias and paroxysmal atrial tachycardia evoked by emotion, so it is not contraindicated for patients with these conditions. It lowers blood pressure, so it would be helpful in patients with hypertension.

Answer to Question 2

ANS: B
This patient is showing signs that are common with high therapeutic levels of lidocaine. Because lidocaine is rapidly degraded, slowing the rate of infusion can help remove excess drug from the circulation. Seizures are possible with toxic doses; diazepam should be used to control seizures. It is not necessary to discontinue the infusion, because this patient is showing signs common to high therapeutic doses. Respiratory arrest is possible with toxic doses; mechanical ventilation may be needed.

[Yi-Chen]

Thanks for the timely response, appreciate it

[juliaf]

Gracias!