When starting a patient on antidysrhythmic therapy, the nurse will remember that which problem is a potential adverse effect of any antidysrhythmic drug?

Correct Answer: D

Rationale: While it may seem counterintuitive that starting a patient on antidysrhythmic therapy could potentially cause dysrhythmias, it is important to remember that antidysrhythmic drugs can have proarrhythmic effects. Proarrhythmia refers to the development of new or more severe dysrhythmias as a result of the medication intended to treat dysrhythmias. This can occur due to various mechanisms, such as altering the electrical conduction system of the heart or disrupting the normal rhythm. Therefore, dysrhythmias are a potential adverse effect that the nurse should monitor for when initiating antidysrhythmic therapy in a patient. It is crucial for the healthcare team to closely monitor the patient's cardiac rhythm and adjust the medication regimen as needed to minimize the risk of proarrhythmia.

Correct Answer: C

Rationale: First-generation antihistamines can cause paradoxical central nervous system (CNS) stimulation in children, leading to hyperactivity, agitation, and insomnia. This is contrary to their sedative effects in adults. Reye's syndrome is associated with aspirin, not antihistamines. Cholinergic effects and gastrointestinal symptoms are less common in children.

Correct Answer: A

Rationale: Propranolol is a medication that belongs to the class of drugs known as beta blockers. Beta blockers work by blocking the effects of the stress hormones adrenaline and noradrenaline on the beta receptors in the body. By blocking these receptors, propranolol helps to reduce heart rate, blood pressure, and the workload on the heart, making it effective in the treatment of conditions such as high blood pressure, angina, and certain heart rhythm disorders.

Correct Answer: D

Rationale: The nurse should withhold administration of the medication and notify the physician. The apical pulse of 58 bpm is below the normal range (60-100 bpm for adults), and propranolol is a beta-blocker that can further decrease the heart rate. Administering propranolol at this low heart rate may cause bradycardia (excessively slow heart rate) which can lead to serious complications. It is important to inform the physician of the low heart rate so that appropriate action or further assessment can be taken before administering the medication.

Correct Answer: B

Rationale: Furosemide belongs to the therapeutic class of diuretics. Diuretics are medications that promote diuresis, which is the increased production of urine. Furosemide specifically belongs to the loop diuretic class, working by inhibiting the reabsorption of sodium and chloride in the loop of Henle in the kidney, leading to increased excretion of water and electrolytes. This mechanism makes it a commonly used medication for conditions such as congestive heart failure, edema, and hypertension.