Exam 23: Antiarrhythmic Agents

A patient who has been taking quinidine for several years reports lightheadedness,fatigue,and weakness.The primary care NP notes a heart rate of 110 beats per minute.The serum quinidine level is 6 µg/mL.The NP should:

A patient undergoes a routine electrocardiogram (ECG),which reveals occasional premature ventricular contractions that are present when the patient is resting and disappear with exercise.The patient has no previous history of cardiovascular disease,and the cardiovascular examination is normal.The primary care NP should:

Persistent atrial fibrillation (AF)is diagnosed in a patient who has valvular disease,and the cardiologist has prescribed warfarin (Coumadin).The patient is scheduled for electrical cardioversion in 3 weeks.The patient asks the primary care nurse practitioner (NP)why the procedure is necessary.The NP should tell the patient:

The primary care NP refers a patient to a cardiologist who diagnoses long QT syndrome.The cardiologist has prescribed propranolol (Inderal).The patient exercises regularly and is not obese.The patient asks the NP what else can be done to minimize risk of sudden cardiac arrest.The NP should counsel the patient to:

A patient comes to the clinic with a history of syncope and weakness for 2 to 3 days.The primary care NP notes thready,rapid pulses and 3-second capillary refill.An ECG reveals a heart rate of 198 beats per minute with a regular rhythm.The NP should:

A patient who is taking trimethoprim-sulfamethoxazole for prophylaxis of urinary tract infections tells the primary care NP that a sibling recently died from a sudden cardiac arrest,determined to be from long QT syndrome.The NP should:

The primary care NP sees a new patient for a routine physical examination.When auscultating the heart,the NP notes a heart rate of 78 beats per minute with occasional extra beats followed by a pause.History reveals no past cardiovascular disease,but the patient reports occasional syncope and shortness of breath.The NP should: