A patient is suspected of having a decreased cardiac output due to dysrhythmias. Which of the following assessments would be included in a decreased cardiac output? Select all that apply

Correct Answer: A

Rationale: The correct answer is A: Elevated jugular venous distention. This is a classic sign of decreased cardiac output as it indicates increased central venous pressure due to the heart's inability to effectively pump blood. This results in blood backing up into the jugular veins, causing them to appear distended. Explanation for why other choices are incorrect: B: Polyuria is not typically associated with decreased cardiac output. Polyuria is excessive urination and is more commonly seen in conditions such as diabetes insipidus or diabetes mellitus. C: Full and bounding pulses are not indicative of decreased cardiac output. In fact, decreased cardiac output often leads to weak and thready pulses due to reduced blood flow. D: Diaphoresis, or excessive sweating, can occur in various conditions but is not a specific sign of decreased cardiac output. It can be seen in response to pain, anxiety, or fever.

Correct Answer: A

Rationale: The correct order for the nurse to question is A: The addition of a loop diuretic with digoxin. This is because loop diuretics can increase the risk of digoxin toxicity by causing hypokalemia. Digoxin toxicity is more likely to occur when potassium levels are low. Therefore, the nurse should question this order to prevent potential harm to the patient. Summary: - B: The addition of a beta blocker with digoxin: Beta blockers can also increase the risk of digoxin toxicity but it is not as directly related to potassium levels as loop diuretics. - C: A digoxin dose of 0.125 mg per day: This is within the recommended therapeutic range for digoxin and does not directly impact the risk of toxicity with loop diuretics. - D: The addition of an ACE inhibitor with digoxin: ACE inhibitors can also increase the risk of digoxin toxicity, but the priority in this case is

Correct Answer: C

Rationale: The correct answer is C: Dysrhythmias. Cardio-selective beta blockers are commonly used to manage dysrhythmias by blocking the effects of adrenaline on the heart, helping to regulate the heart rate and rhythm. This is achieved by blocking beta-1 receptors in the heart, without affecting beta-2 receptors in the lungs. Incorrect choices: A: Hypotension - Beta blockers can actually worsen hypotension by reducing the heart rate and cardiac output. B: Hypertension - While beta blockers can be used to treat hypertension, cardio-selective beta blockers are not typically the first choice for this condition. D: Cardiac arrest - Beta blockers are used in some cases to prevent cardiac arrest, but they are not the primary treatment for this emergency situation.

Correct Answer: D

Rationale: Flecainide is a Class IC antiarrhythmic medication. Class IC antiarrhythmics block sodium channels in the heart, slowing conduction velocity. This helps in treating tachyarrhythmias. Choices A and C are both listed as Class IB, which work by blocking sodium channels but have different effects on action potential duration compared to Flecainide. Choice B, Class II, works by blocking beta-adrenergic receptors and is not the correct class for Flecainide. Therefore, the correct answer is D as Flecainide belongs to Class IC due to its mechanism of action.

Correct Answer: C

Rationale: The correct answer is C: Renal artery stenosis. ACE inhibitors can lead to decreased renal blood flow, which can worsen renal artery stenosis. This can result in decreased kidney function and potentially lead to renal failure. A: Hypertension is not a contraindication to taking ACE inhibitors, as they are commonly used to treat hypertension. B: Bronchospasm is not a contraindication to taking ACE inhibitors, as they are not known to worsen bronchospasm. D: Heart failure is not a contraindication to taking ACE inhibitors, as they are commonly used to treat heart failure by reducing strain on the heart.