Question

The nurse is caring for a patient who is receiving a new antidysrhythmic medication intravenously. Explain the immediate nursing interventions and considerations (explain the rationale).   

Answer 1

Nurses responsibilities in administering anti dysrhythmic medication intravenously:

• Medications that are being given for a crisis circumstance, for example, a deadly dysrhythmia or stun state, will be for the most part managed intravenously for fast dissemination.
• Intravenous boluses (IV pushes) are given gradually while understanding is nearly checked by wanted parameter, imperative signs, and physical evaluation.
• Stacking measurements for some antidysrhythmic pharmaceuticals are required on the grounds that they tie to plasma proteins (particularly egg whites). Plasma protein receptor destinations must be loaded with particles of a medication before atoms being free in the plasma for helpful purposes. Serum levels of a medication speak to the grouping of particles that are not bound to plasma proteins. On the off chance that a patient has low levels of plasma proteins (like hypoalbuminemia), at that point serum levels of meds can be higher than typical for similar measurements. Additionally, medicate communications are frequently affected by dislodging of one medication by another medication off plasma proteins. Medication associations on plasma proteins can cause serum levels to wind up raised or subtherapeutic.
• Numerous antidysrhythmic drugs have limit restorative reaches (record), in this way serum levels are checked intermittently and medical caretakers must perceive indications of lethality.
• Support measurements of heart drugs are for the most part regulated at even time interims to keep up restorative serum levels.
• Intravenous implantations of medicines ought to NEVER be hindered or ceased for IVPB prescriptions, IV pushes, or different intravenous intercessions. Utilize a moment IV line for other IV treatments with the goal that serum levels of prescription implantations don't wind up changed.
• Be alarm for changes in electrolyte adjusts, particularly potassium (K+).
• For organization of single support dosages of antidysrhythmia meds, CHECK APICAL HEART RATE (HR) FOR 1 FULL MINUTE. Hold the drug if HR < 60/min or > 120/min. On the off chance that this circumstance exists amid an upkeep measurement, at that point ask yourself whether your patient is steady. Don't SIMPLY CHART THE HEART RATE AND LEAVE YOUR PATIENT! Ask the patient how s/he is feeling (e.g., unsteadiness, wooziness, chest torment, dyspnea). Survey other fundamental signs like circulatory strain and breaths. Check cardiovascular screen for nearness of dysrhythmias. Evaluate the historical backdrop of imperative signs in the diagram. Survey research facility comes about for electrolytes. Return and reassess apical heart rate again in 15-30 minutes. In the event that the patient is temperamental, tell the doctor STAT. In the event that the patient is steady, at that point advise the doctor of the change (prescription was held) and the reason amid the doctor's visit to the patient.
• The patient needs to figure out how to gauge one' claim beat. Demonstrate to the patient proper methodologies to locate one's own outspread heartbeat. Educate the patient to exclude the beat noisy while you screen the beat at another site. Train the patient to survey one's heartbeat day by day in the meantime of day, ideally when one first awakens or when the drug is booked. Prompt the patient under what conditions to inform the doctor.
• CHECK THE PATIENT'S BLOOD PRESSURE PRIOR TO ADMINISTERING AN ANTIDYSRHYTHMIC MEDICATION OR HEMODYNAMIC MEDICATION (like vasodilators). In the event that systolic pulse is < 100 mm Hg or 30 mm Hg beneath gauge, at that point hold prescription. On the off chance that one of these circumstances exist, at that point ask yourself whether your patient is steady. Don't SIMPLY CHART THE BLOOD PRESSURE AND LEAVE YOUR PATIENT! Ask the patient how s/he is feeling (e.g., discombobulation, dazedness, chest torment, dyspnea). Search for postural hypotension. Survey other fundamental signs like heartbeat and breaths. Check cardiovascular screen for nearness of dysrhythmias. Evaluate the historical backdrop of crucial signs in the diagram. Evaluate research facility comes about for electrolytes. Return and reassess circulatory strain again in 15-30 minutes. On the off chance that the patient is insecure, advise the doctor STAT. In the event that the patient is steady, at that point illuminate the doctor of the fluctuation (drug was held) and the reason amid the doctor's visit to the patient.
• Remember that in the event that you are treating a patient for a dangerous circumstance, the essential signs will as of now be outside of typical parameters. The drug is the intercession to settle the patient. So comprehend what your prescriptions do, and utilize your insight while directing cardiovascular meds.
• Watch for gastrointestinal changes, for example, queasiness, regurgitating, and loose bowels. At the point when an adjustment exists, survey for electrolyte lopsided characteristics or lethality of a cardiovascular pharmaceutical.
• Evaluate for liquid maintenance through every day weights while the patient is in the healing facility. (Weight can be surveyed every other week by the patient at home.)
• Evaluate the heart screen each move. Measure the PR interim, the QRS span, QT interim, and atrial and ventricular rates.