NRSG 3100 Exam #4 with complete solutions Ventricular pulse rate
40-30
AV pacer rate
60-405
01:12
01:21
What is makes up stroke volume
preload, afterload, and contractility
Normal stroke volume
60-70%
TTE vs TEE
transthoracic vs transesophageal echocardiogram. TEE...
, NRSG 3100 Exam #4
Signs of cardiotoxicty caused by Na channel blockers - Answer increased PR and QT
intervals and/or widening QRS
Class IA Na channel blockers - Answer Procainamide (Pronestryl)
Class IB Na channel blockers - Answer lidocaine (Xylocaine)
Class of Procainamide (Pronestyl) - Answer Broad spectrum anti-dysrthymias used for
both atrial and ventricular arrhythmias
MOA of procainamide (Pronestyl) - Answer blocks sodium channels in myocardial cells;
reducing automaticity and slowing velocity of the action potential across the
myocardium
When is procainamide given - Answer Considered a drug of last resort for cardiac life
support due to its toxicity; used when other drugs have failed to reverse severe
dysrhythmia
Most common, serious side effects of procainamide - Answer Confusion of psychosis
BBW for procainamide (Pronestyl) - Answer Chronic use may result in a lupus-like
syndrome (increased ANAs)
Blood dyscrasias (monitor CBC, discontinue at first sign of possible dyscrasias)
When to not give procainamide (Pronestyl) - Answer 2nd or 3rd degree AV block!!!
severe HF, peripheral neuropathy, myasthenia gravis, lupus!!!
use caution with bone marrow depression
NC for procainamide (Pronestyl) - Answer Supine position during IV administration due
to risk of severe hypotension
Terminate if QRS widens more than 50%
Narrow therapeutic index (serum levels 4-8 mcg/mL)
Patient education about procainamide (Pronestyl) - Answer Do not take any other
medications or supplements without physician approval
Report any excessive bruising or bleeding (blood dyscrasias)
MOA of lidocaine (Xylocaine) - Answer Lidocaine raises the ventricular stimulation
threshold during diastole
Which arrhythmias does lidocaine (Xylocaine) treat - Answer Ventricular
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