Difficulty: Medium
Average Score: 79%
Simulated
A 78-year-old client is admitted to the emergency department with a heart rate of 34 beats/min. Family members tell the nurse that the client may have mistakenly taken several doses of donepezil. The nurse should anticipate what intervention to treat the client's bradycardia?
Correct answer
A
Rationale
Correct Answer: A - STAT administration of atropine
Rationale:
1. Bradycardia (heart rate <60 bpm) can be a side effect of cholinesterase inhibitors like donepezil.
2. Atropine is a muscarinic antagonist that increases heart rate by blocking the parasympathetic nervous system.
3. Atropine is indicated for symptomatic bradycardia, especially in cases of cholinesterase inhibitor toxicity.
Summary:
B: Activated charcoal is used to absorb ingested toxins but is not indicated for bradycardia due to cholinesterase inhibitors.
C: Hemodialysis is used for drug removal in cases of overdose but is not the primary treatment for bradycardia.
D: Pseudoephedrine is a sympathomimetic agent that can increase heart rate, but atropine is the first-line treatment for bradycardia.
Rationale:
1. Bradycardia (heart rate <60 bpm) can be a side effect of cholinesterase inhibitors like donepezil.
2. Atropine is a muscarinic antagonist that increases heart rate by blocking the parasympathetic nervous system.
3. Atropine is indicated for symptomatic bradycardia, especially in cases of cholinesterase inhibitor toxicity.
Summary:
B: Activated charcoal is used to absorb ingested toxins but is not indicated for bradycardia due to cholinesterase inhibitors.
C: Hemodialysis is used for drug removal in cases of overdose but is not the primary treatment for bradycardia.
D: Pseudoephedrine is a sympathomimetic agent that can increase heart rate, but atropine is the first-line treatment for bradycardia.