Sinus tachycarida?

MrsMig, BSN, RN · Apr 9, 2011

Digixon is for BP & HTN - would never administer w/o apcial & MD order AND would NEVER be for a sinus some-thing-arouther.....

W/o knowing the other question option, I'm wondering the question/answer....

shaas, ASN, RN · Apr 9, 2011

Hi, there.

One thing that I can think of is that, in this situation, sinus tachycardia may have been caused by fever or pain (both elevate HR). And, there is no electrical/conduction problem as far as I can tell from the question's stem. The conduction began normally at SA node, hence labeled "sinus" tachycardia.

By alleviating the pain or fever, which may be the possible cause (because it does not give you any other physiological clues), you can bring down the HR, hence, acetaminophen is the most reasonable answer that I can arrive at.

And, unfortunately, no. Your instructor is not mistaken here.

EricaSAFJAF · Apr 9, 2011

Digixon is for BP & HTN - would never administer w/o apcial & MD order AND would NEVER be for a sinus some-thing-arouther.....
W/o knowing the other question option, I'm wondering the question/answer....

dig is for heart rate..it lowers heart rate.

EricaSAFJAF · Apr 9, 2011

Hi, there.
One thing that I can think of is that, in this situation, sinus tachycardia may have been caused by fever or pain (both elevate HR). And, there is no electrical/conduction problem as far as I can tell from the question's stem. The conduction began normally at SA node, hence labeled "sinus" tachycardia.
By alleviating the pain or fever, which may be the possible cause (because it does not give you any other physiological clues), you can bring down the HR, hence, acetaminophen is the most reasonable answer that I can arrive at.
And, unfortunately, no. Your instructor is not mistaken here.

k thanks, I know fever can increase heart rate, but the question did not state the patient had a fever ya know? I just felt it was silly for me to assume patients tachycardia was caused by fever when it could be something else.. such a vague question lol

shaas, ASN, RN · Apr 9, 2011

Digoxin does address HR, more specifically myocardial contractility, but you should really look it up. You need to ask: it decreases HR by addressing what sort of conduction problem and what mechanism of action?

For future reference: digoxin is indicated for atrial fibrillation (abnormal conduction site and rate).

Good luck. :)

NurseLoveJoy88, ASN, RN · Apr 9, 2011

I would of chose giving the tyelenol as well. With Sinus tach you always want to treat the underlying cause first.

suanna · Apr 9, 2011

I was taught that sinus tachycardia is never a problem, it is a response to a problem. You don't treat the sinus tachycardia- you treat what is causing it. It was not ectopic, so digoxin isn't the best choice, ablation of the sinus node- sure it would cure the sinus tachycardia- but so would a gun shot to the head.(not a good choice either way). The "can't remember" choice I can't say much about, but I bet, somewhere in the patient description you got a clue about fever. Fever and/or dehydration are almost the most common cause of sinus tachycardia. (after anxiety)

MrsMig, BSN, RN · Apr 9, 2011

dig is for heart rate..it lowers heart rate.

Yeah - I know what it does (and your heart rules your BP/output)...but you just don't administer when someone is tachycardic. It's a long-term script med and it's not used prophylatically.

VickyRN, MSN, DNP, RN · Apr 9, 2011

I agree with the previous poster who stated sinus tachycardia is always secondary to another condition.

It is an important compensatory mechanism for the body. Therefore, you would not treat the sinus tachycardia directly (as with digoxin), but you would treat the underlying cause.

If dehydration, you would rehydrate.

If hypoxia, you would oxygenate.

If fever, you would implement measures to lower the body temperature.

If anxiety, you would implement measures to treat the anxiety.

If pain, you would implement comfort measures.

The only possible "correct" answer, therefore, is "B."

Hope this helps.

dudette10, MSN, RN · Apr 9, 2011

IMO, that test question is awful! Next time, don't give the answer in the OP to see what kind of responses you get.

Even with the responses here that justify acetaminophen, I don't see how a nursing student would answer that rather than digoxin, given the question. The question doesn't say anything about a fever.

shaas, ASN, RN · Apr 10, 2011

It is very true that not all students will perform at the same level despite having given the same instruction and material on the subject matter; therefore, they'd test differently as well.

I believe that the biggest clue was not just tachycardia, but sinus tachycardia. This should trigger thoughts of conduction, contractility, rate, and what conditions induce sinus tachycardia. And, if the student already knows that digoxin has something to do with HR, that means the student had looked the medication up some point in her life, as that specific knowledge is not inherent in her genome. The depth of knowledge is what seems to be the issue. Digoxin specifically works in a certain way (mechanism of drug action) and is indicated for certain conditions because of how it works.

One can choose to justify that no fundamentals student would answer this correctly, but there is always someone who "gets" what others perceive as too elusive to procure or too vague to grasp. If I were the OP, I'd introspect where I went wrong and compensate for that deficiency so that I would perform better next time. One gains more by admitting one's shortcomings than justifying the error itself.

I wish the best of luck to the OP.

Shaas