A client who is admitted to the hospital for treatment of premature ventricular contractions (PVCs) says, "I took a medicine called procainamide years ago when I had PVCs and it worked great
I quit taking it because I did not think I needed it anymore. Maybe the doctor can give me some of that." Which responses by the nurse are appropriate?
Standard Text: Select all that apply.
1. "You must be confused, because procainamide is not given orally."
2. "I will be certain to let the doctor know that. He might just restart your medication."
3. "Procainamide is given for arrhythmias that come from a different part of the heart than yours."
4. "Procainamide is no longer the drug of choice for your type of arrhythmia."
5. "Procainamide has some serious side effects and we have better drugs for your condition now."
Correct Answer: 4,5
Rationale 1: The medication is only given intravenously or intramuscularly now, but it was once also an oral medication.
Rationale 2: Procainamide is no longer available in a dosage form that can be taken at home.
Rationale 3: Procainamide is given for ventricular arrhythmias.
Rationale 4: Procainamide is now considered the drug of "last choice" for advanced cardiac life support due to its toxicity.
Rationale 5: Procainamide has a narrow therapeutic index, and dosage must be monitored carefully to avoid serious adverse effects.
Global Rationale: Procainamide is now considered the drug of "last choice" for advanced cardiac life support due to its toxicity. Procainamide has a narrow therapeutic index, and dosage must be monitored carefully to avoid serious adverse effects. The medication is only given intravenously or intramuscularly now, but it was once also an oral medication. Procainamide is no longer available in a dosage form that can be taken at home. Procainamide is given for ventricular arrhythmias.
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