A patient with diabetes develops ventricular tachycardia and is ...

[serike]

A patient with diabetes develops ventricular tachycardia and is in the hospital for evaluation of this condition.
 
  The nurse reviews the history and learns that the patient takes mexiletine (Mexitil) for pain caused by peripheral neuropathy. What does the nurse do?
  a. Discuss common side effects associated with taking mexiletine with cardiac agents.
  b. Understand that this drug will help with both peripheral neuropathy and dysrhythmias.
  c. Notify the provider to request that another drug be used for peripheral neuropathy pain.
  d. Request an order for renal function and hepatic function tests.

Question 2

A nurse is providing teaching to a patient who is admitted to the hospital for initiation of treatment with amiodarone (Cordarone) for atrial fibrillation that has been refractory to other medications.
 
  Which statement by the patient indicates a need for further teaching?
  a. I may have itching, malaise, and jaundice, but these symptoms will subside.
  b. I need to use sun block to help keep my skin from turning bluish gray.
  c. I should not drink grapefruit juice while taking this medication.
  d. I should report shortness of breath and cough and stop taking the drug immediately.

[eliasc0401]

Answer to Question 1

ANS: C
Mexiletine is an antidysrhythmic medication that can also cause dysrhythmias. It is used to treat the pain associated with peripheral neuropathy in diabetic patients, but it is contraindicated in diabetic patients with heart disease and so should be stopped now that this patient has developed a heart disorder. Because it is contraindicated, the nurse will not teach the patient about side effects with other agents. It can exacerbate cardiac symptoms, so it should not be used to treat dysrhythmias in diabetic patients. There is no indication for tests of renal and hepatic function.

Answer to Question 2

ANS: A
Amiodarone has many toxic effects. Liver toxicity is rare but serious and should be reported and the drug discontinued. Dermatologic toxicity can occur, and sun block helps protect the skin, which, with prolonged exposure to the sun, can turn bluish gray. Drinking grapefruit juice can increase amiodarone levels. Pulmonary toxicity is the greatest concern, and patients with pulmonary symptoms should report these to the provider.

[serike]

Gracias!

[raenoj]

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