Author Question: A client is admitted to the emergency department (ED) with new-onset atrial fibrillation. Which ... (Read 23 times)

scienceeasy · **on:** Jul 23, 2018

A client is admitted to the emergency department (ED) with new-onset atrial fibrillation. Which cardiac rhythm history would be a contraindication for the use of a sodium channel blocker antidysrhythmic medication?

1. Occasional premature ventricular contractions (PVCs)
2. Multiple premature atrial contractions (PACs)
3. Elevated blood sugar
4. Second-degree AV block

Question 2

A client in the emergency department complains of chest pain, diaphoresis, shortness of breath, lightheadedness, and dizziness.

The cardiac monitor displays ventricular tachycardia at 180 beats per minute. What is the nurse's most immediate concern for this client?
1. The client may be experiencing a posterior myocardial infarction.
2. The client may suffer a cerebral vascular accident.
3. The client is at risk for development of a pulmonary embolism.
4. The client is at risk for cardiac death.

aadams68 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: Sodium channel blockers may be used to control PVCs.
Rationale 2: Sodium channel blockers may be used to control PACs.
Rationale 3: Sodium channel blockers do not have a direct correlation with blood sugar levels.
Rationale 4: Sodium channel blockers slow the action potential and delay conduction, therefore risking complete heart block and cardiac arrest if used on a client with a history of existing second- or third-degree block.
Global Rationale: Sodium channel blockers slow the action potential and delay conduction, therefore risking complete heart block and cardiac arrest if used on a client with a history of existing second- or third-degree block. Sodium channel blockers may be used to control PVCs, PACs, and do not have a direct correlation with blood sugar levels.

Answer to Question 2

Correct Answer: 4
Rationale 1: While a myocardial infarction may occur, this is not the most immediate concern.
Rationale 2: A cerebral vascular accident may occur, but this is not the most immediate concern.
Rationale 3: Prevention of an embolism is not first priority.
Rationale 4: The most vital concern is deterioration into cardiac arrest. If not treated quickly, the client will die due to lack of circulation of oxygen.
Global Rationale: The most vital concern is deterioration into cardiac arrest. If not treated quickly, the client will die due to lack of circulation of oxygen. While a myocardial infarction and cerebral vascular accident may occur, these are not the most immediate concern. Prevention of an embolism is not first priority.