Which is the most suitable option here? A client has a heart rate of 170 beats/minute. The physician diagnoses ventricular tachycardia and orders lidocaine hydrochloride (Xylocaine), an initial I.V. bolus of 50 mg followed in 5 minutes by a second 50-mg bolus, then continuous I.V. infusion at 2 mg/minute. The nurse can expect the client to begin experiencing an antiarrhythmic effect within ___.
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A. 1 to 2 minutes after I.V. bolus administration. B. 1 to 2 minutes after continuous I.V. infusion. C. 10 to 15 minutes after I.V. bolus administration. D. 10 to 15 minutes after continuous I.V. infusion.
The lidocaine infusion starts to effect in about 1-2 minutes. This is because these antiarrhythmic drugs are short acting. The bolus is given to kick start the process resulting in rapid action. However, the infusion is continued to make sure that lidocaine continues its effect.
The drug vanes off about 15 minutes after the lidocaine infusion is stopped. This means that the patient needs immediate pharmacological or surgical intervention once the lidocaine infusion is stopped. Arrhythmias can be difficult to control. Especially ventricular tachycardia has a tendency to go into ventricular fibrillation that can be fatal for the patient.
1 to 2 minutes after i.v. bolus administration.-rationale: lidocaine exerts its antiarrhythmic effect in 1 to 2 minutes after i.v. bolus administration. a continuous i.v. infusion will maintain lidocaines antiarrhythmic effect for as long as the drip is used. lidocaine provides antiarrhythmic effects for only 15 minutes after the i.v. infusion is stopped.client needs category: physiological integrityclient needs subcategory: pharmacological and parenteral therapiescognitive level: analysisreference:springhouse nurses drug guide 2007. philadelphia: lippincott williams & wilkins, 2007, p. 774.