Cardiac Glycosides, Antianginals, and Antidysrhythmics Class IV Antidysrhythmic Therapy (Calcium Channel Blockers)

Which effect on the electrocardiogram (ECG) will the nurse expect to see in a patient who is receiving a Class IV antidysrhythmic drug?
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Terms in this set (18)
Which effect on the electrocardiogram (ECG) will the nurse expect to see in a patient who is receiving a Class IV antidysrhythmic drug?
Prolonged PR interval
Class IV antidysrhythmic drugs prolong PR intervals, which delays the atrioventricular conduction, thereby decreasing the heart rate.
Question 2 of 4
Which statement is an accurate description of the mechanism of action for verapamil?
Blocks the slow influx of calcium ions into slow calcium channels
Calcium channel blockers block the slow influx of calcium ions into the slow calcium channels.
Which cardiovascular condition is treated with nondihydropyridine calcium channel blockers?
Supraventricular tachycardia
Calcium channel blockers are indicated for supraventricular tachycardia, atrial dysrhythmias, hypertension, and angina.
Which route of administration for verapamil is appropriate for maintenance therapy?
Oral
Oral verapamil is administered for maintenance therapy. Oral verapamil is usually administered along with digoxin.
Which of Mr. Allen's vital sign findings will indicate to the nurse to hold the verapamil?
Pulse of 56 beats/min
Calcium channel blockers should be held when the pulse is below 60 beats/minutes or when systolic blood pressure is 90 mm Hg or lower.
The nurse notes Mr. Allen, who is taking verapamil, has edema to his ankles and feet. Which medical condition would the nurse suspect as the cause?
Heart failure
Class IV antidysrhythmic drugs, such as verapamil, could cause heart failure. Swelling of the ankles and feet could be an early indicator of heart failure.
Which statement is accurate regarding the interaction between verapamil and grapefruit juice?
Grapefruit juice can inhibit the metabolism of verapamil.
Grapefruit juice can inhibit the metabolism of verapamil, raising serum drug levels with potential toxicity.
A patient is noted to be experiencing a cardiac dysrhythmia. Which parameter would the nurse use to administer a bolus dose of diltiazem?
Intravenously slowly over 2 minutes
Diltiazem intravenous should be administered slowly over 2 minutes while monitoring the cardiac rhythm for any changes in rate or rhythm.
Which instruction would the nurse provide a patient about the proper administration of extended-release diltiazem?
Swallow whole without crushing or chewing.
Extended-release tablets of diltiazem should be swallowed whole, without crushing or chewing.
Question 1 of 9
A nurse administered diltiazem intravenously at 0900. At which time will the nurse assess the patient for therapeutic effects of diltiazem?
0905
The onset of therapeutic effects of diltiazem intravenously is 3 minutes. The peak effect is in 15 minutes. The nurse will assess the effects at 0905.
Question 2 of 9 A nurse would question a prescription for verapamil in a patient diagnosed with which condition?Heart failure Verapamil should be used cautiously in patients with heart failure. Calcium channel blockers decrease contractility of the vessels and decrease total peripheral resistance, blood pressure, and cardiac workload.Question 3 of 9 The nurse is assessing a patient who is taking verapamil for atrial fibrillation and notes 1+ edema to the ankles and feet. Which action would the nurse take?Assess the patient for heart failure. 1+ edema could indicate early heart failure. The nurse should monitor closely for further evidence of heart failure, such as dyspnea, crackles on lung auscultation, and weight gain. Caution is advised in patients with heart failure when administering verapamil.Question 4 of 9 Before administering diltiazem, the nurse observes the patient's pulse at 54 beats/min on the cardiac monitor. Which action will the nurse take next?Hold the drug. A pulse of 54 beats/min is considered bradycardia, which could indicate an adverse effect of diltiazem. The next action after assessing the pulse is to hold the drug.Question 5 of 9 Which instruction will the nurse provide on avoiding side effects related to diltiazem?Increase dietary fiber. One side effect of diltiazem is constipation. Increasing dietary fiber can prevent constipation.Question 6 of 9 A health care provider prescribes diltiazem 10 mg intravenous push for persistent atrial fibrillation with a ventricular rate of 115 beats/min. While preparing the diltiazem, the nurse notices the patient is on digoxin 0.125 mg and metoprolol 25 mg. Which action will the nurse take?Hold the diltiazem. The nurse would hold the diltiazem until the prescription can be clarified with the health care provider. Giving diltiazem to a patient who is already taking digoxin and metoprolol could suppress the cardiac function and cause severe bradycardia, decrease atrioventricular conduction, and decrease cardiac contractility. Beta blockers and diltiazem should be administered several hours apart to minimize the risk of cardiosuppression.Question 7 of 9 A patient who is being discharged on diltiazem tells the nurse that cooking with herbs and taking supplements has improved the patient's physical stamina. Which response by the nurse is appropriate?"Certain supplements can alter the therapeutic effects of diltiazem." The nurse would provide teaching on drug-drug, drug-herb, and drug-food interactions. Grapefruit juice, ginkgo, ginseng, hawthorn, and St. John's wort could increase the drug level of diltiazem, increasing the risk of side or adverse effects. The patient should consult with the health care provider or pharmacist before consuming any herb.Question 8 of 9 A patient who is receiving verapamil asks the nurse how the drug helps the heart. The nurse responds knowing that verapamil has which mechanisms of action? CorrectSlowing of sinoatrial (SA) node automaticity The blockade of cardiac calcium channels by verapamil makes atrial tissues more refractory to stimulation, slowing the SA node automaticity. Delay of AV nodal conductionThe blockade of cardiac calcium channels by verapamil delays conduction at the AV node. Reduction of myocardial contractilityThe blockade of cardiac calcium channels by verapamil reduces the excitability and contractility (negative inotrope) of the myocardium.Question 9 of 9 A patient with atrial fibrillation is being discharged on verapamil. Which symptoms will the nurse instruct the patient to report to the health care provider?Weight gain Signs and symptoms of heart failure, such as weight gain, should be reported to the health care provider. Dyspnea Dyspnea could be a sign of heart failure. It should be reported. Swelling to feet and ankles Swelling to ankles and feet could be signs of heart failure. They should be reported.