A patient is in the intensive care unit because of an acute myocardial infarction. He is experiencing severe ventricular dysrhythmias. The nurse will prepare to give which drug of choice for this dysrhythmia?

Correct Answer: C

Rationale: Amiodarone is the drug of choice for treating severe ventricular dysrhythmias, such as those experienced by the patient in the intensive care unit with acute myocardial infarction. It is a class III antiarrhythmic medication that works by prolonging the action potential duration and refractory period, thereby helping to stabilize the electrical activity of the heart. Amiodarone is effective in treating various types of ventricular dysrhythmias, including ventricular tachycardia and ventricular fibrillation, making it a suitable choice in this scenario. Diltiazem and verapamil are calcium channel blockers primarily used for supraventricular arrhythmias and are not the first-line treatment for severe ventricular dysrhythmias. Adenosine is used for terminating supraventricular tachycardias, not ventricular dysrhythmias. Amiodarone

Correct Answer: D

Rationale: Milrinone and furosemide are two medications that are known to interact when mixed together in the same intravenous line. Milrinone is a phosphodiesterase inhibitor that works to increase cardiac contractility and output, while furosemide is a loop diuretic used to promote diuresis. When mixed together, the pH level of the solution can become altered, leading to potential precipitation or inactivation of one or both drugs.

Correct Answer: C

Rationale: Propranolol is the drug that undergoes extensive first-pass hepatic metabolism. First-pass metabolism refers to the metabolism of a drug by the liver before it enters the systemic circulation. In the case of propranolol, a significant portion of the drug is metabolized by the liver before reaching the systemic circulation, leading to reduced bioavailability. This is why propranolol is often given in higher doses to achieve the desired therapeutic effect. Heparin, insulin, nitroglycerine, and warfarin do not undergo significant first-pass metabolism by the liver.

Correct Answer: A

Rationale: Common side effects of iron supplements include constipation, upset stomach, and nausea. Iron supplements can cause gastrointestinal side effects such as constipation, upset stomach, and nausea. These side effects usually improve over time or can be managed by taking the supplement with food or adjusting the dosage. It is important to speak with a healthcare provider if these side effects persist or worsen.

Correct Answer: A

Rationale: When a patient is on Warfarin therapy, the two primary tests that need to be monitored are the Prothrombin Time (PT) and the International Normalized Ratio (INR). Warfarin works by inhibiting the activity of Vitamin K-dependent clotting factors, and both PT and INR are measures of the extrinsic pathway of coagulation, which is primarily affected by Warfarin. PT measures the time it takes for blood to clot, while INR is a standardized calculation based on the PT value to monitor the effectiveness and safety of Warfarin therapy. Monitoring these tests helps ensure that the patient's blood is not too thick (increased risk of clotting) or too thin (increased risk of bleeding) while on Warfarin.