When administering an antiarrhythmic agent, which of the following assessment parameters is the most important for the nurse to evaluate?
A. ECG
B. Pulse rate
C. Respiratory rate
D. Blood pressure
Correct Answer: A. ECG
The ECG is the most important parameter to assess. Vital signs such as RR, PR, and BP need to be monitored, but the ECG is the most important. The benefit of the classification is in the primary mechanism of action, and the broad, predictable side effects brought about by the primary mechanism. An example would include the class III K+ channel blockers or “repolarization” blockers producing a prolonged phase 3 of the action potential and, by definition, also leading to a prolonged QT interval on the corresponding ECG.
Option B: Therapy with beta-blockers may have cardiovascular side effects such as bradycardia and AV block. Noncardiac side effects of beta-blockers include exacerbation of asthma and COPD, lethargy, and dyslipidemia. Along with its needed effects, verapamil may cause some unwanted effects such as AV block, bradycardia, and constipation. The most frequently reported side effects of diltiazem include edema, headache, and dizziness.
Option C: The adverse effect as bronchospasm makes it contraindicated in asthmatic patients. Adenosine should be avoided in patients with SVT involving accessory pathways (WPW, antidromic AVRT) due to the risk of tachycardia exacerbation.
Option D: Minor adenosine adverse effects include flushing, sense of impending doom, and sweating are usually transient due to the short half-life of the drug. More severe side effects include hypotension, chest pain, AV block, and asystole.