A client in a coronary care unit is being admitted after CPR post cardiac arrest. The client is receiving IV lidocaine at 2 mg/min. When the client asks the nurse why he is receiving that medication, the nurse should explain that it has which of the following actions?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Prevents dysrhythmias. Lidocaine is a class IB antiarrhythmic medication commonly used to treat ventricular dysrhythmias, especially in the setting of acute cardiac events like post-cardiac arrest. Rationale for why A is correct: Lidocaine works by stabilizing the cardiac cell membranes, which helps to prevent abnormal electrical activity that can lead to dysrhythmias. By administering lidocaine, the nurse is helping to maintain the client's cardiac rhythm and prevent potentially life-threatening arrhythmias. Rationale for why B, C, and D are incorrect: B) Slows intestinal motility: Lidocaine does not have a direct effect on intestinal motility. This is not a known action of this medication. C) Dissolves blood clots: Lidocaine is not used to dissolve blood clots. Its primary action is related to its antiarrhythmic properties. D) Relieves pain: While lidocaine is commonly used as a local anesthetic to relieve pain, in this case, the client is receiving it for its antiarrhythmic effects, not for pain relief. Educational context: Understanding the actions of medications like lidocaine is crucial for nurses working in critical care settings such as coronary care units. By knowing the pharmacological properties of medications, nurses can provide safe and effective care to clients with complex medical conditions, like those who have experienced cardiac arrest. This knowledge helps nurses explain the rationale behind medication administration to clients, promoting patient education and involvement in their care.

Correct Answer: B

Rationale: In teaching a client with a new prescription for nitroglycerin patches, the correct instruction to include is to rotate the application site daily (Option B). This is crucial because nitroglycerin patches need to be applied to different sites to prevent skin irritation and ensure optimal drug absorption. By rotating the application site, the client can avoid skin breakdown and potential allergic reactions. Option A (Apply the patch at the same time every day) is incorrect as it does not address the specific need for site rotation and focuses solely on timing. Option C (Remove the patch for 12 hours each day) is incorrect because nitroglycerin patches are typically worn continuously to maintain a consistent therapeutic effect. Option D (Cut the patch in half if needed) is incorrect as altering the patch size can lead to inaccurate dosing and potential overdose. In an educational context, it is important to emphasize the rationale behind the correct instruction to ensure client safety and adherence to medication guidelines. Teaching the client about proper nitroglycerin patch application can help prevent complications and promote effective treatment for their condition.

Correct Answer: B

Rationale: When a client is prescribed furosemide, it is important to monitor for fluid loss. Weighing oneself daily helps track changes in weight due to fluid loss, which can indicate the effectiveness of the medication. This monitoring assists in managing fluid balance and adjusting the dosage if necessary to achieve the desired therapeutic effect.

Correct Answer: A

Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia as an adverse effect. Hyperkalemia is characterized by elevated levels of potassium in the blood, which can be dangerous and lead to cardiac arrhythmias. Therefore, monitoring for signs and symptoms of hyperkalemia is crucial when a client is taking spironolactone.

Correct Answer: B

Rationale: In pharmacology, monitoring laboratory values is crucial to ensure the effectiveness and safety of medications. When a client is receiving vancomycin, monitoring creatinine levels is essential to evaluate the therapeutic effect of the medication. Creatinine levels reflect kidney function, and vancomycin is primarily excreted through the kidneys. Elevated creatinine levels may indicate potential kidney damage or impaired drug clearance, necessitating dose adjustments to prevent toxicity. The other options, BUN, hemoglobin, and white blood cell count, are not directly related to monitoring the therapeutic effect of vancomycin. Blood urea nitrogen (BUN) primarily reflects kidney function but is not as specific as creatinine for monitoring vancomycin therapy. Hemoglobin levels are more relevant for assessing anemia or oxygen-carrying capacity of the blood, while white blood cell count is indicative of the body's immune response and not specific to vancomycin therapy. Educationally, understanding the rationale behind monitoring specific laboratory values for different medications enhances a nurse's ability to provide safe and effective care to clients. It reinforces the importance of pharmacological knowledge in clinical practice and promotes critical thinking skills to make informed decisions regarding medication management based on individual client needs.