CH. 22 PREPU

The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrythmia should the nurse document?

ventricular tachycardia

A nurse is teaching the client about the causes of fast heart rates. What client statement indicates the client requires more teaching?

"I will drink coffee with only two of my meals."

A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching?

"I'll keep a log of each time my ICD discharges."

The nursing student learning on a cardiac unit asks the instructor why loss of the "atrial kick" causes a decrease in cardiac output, because the ventricles are still contracting. What is the nursing instructor's best response?

"The atrial contraction fills the ventricles and accounts for nearly one-third of the volume ejected during ventricular contraction."

The nurse, along with a nursing student, is caring for a client who is admitted with a fractured pacemaker lead related to Twiddler syndrome. The student asks for information about Twiddler syndrome. The appropriate response by the nurse is which of the following?

"The client twiddles with or manipulates the generator or wires, causing the lead to fracture."

The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?

"The only difference is the heart rate."

A client with a second-degree atrioventricular heart block, Type II is admitted to the coronary care unit. How will the nurse explain the need to monitor the client's electrocardiogram (ECG) strip to the spouse?

"The small box will transmit the heart rhythm to the central monitor all the time."

The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse?

"Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."

The licensed practical nurse is setting up the room for a client arriving at the emergency department with ventricular arrhythmias. The nurse is most correct to place which of the following in the room for treatment?

A defibrillator

A nurse provides evening care for a client wearing a continuous telemetry monitor. While the nurse is giving the client a back rub, the client 's monitor alarm sounds and the nurse notes a flat line on the bedside monitor system. What is the nurse's first response?

Assess the client and monitor leads.

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?

Atrial flutter

The nurse knows that electrocardiogram (ECG) characteristics of atrial fibrillation include what?

Atrial rate of 300 to 400

A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia?

Atropine

Which medication is the drug of choice for sinus bradycardia?

Atropine

The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client?

Avoid undergoing magnetic resonance imaging (MRI).

A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next?

Begin cardiopulmonary resuscitation

Which is not a likely origination point for cardiac dysrhythmias?

Bundle of HIs

The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block?

Delayed conduction, producing a prolonged PR interval

A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response?

Document the findings and continue to monitor the client

The nurse receives a client from the postanesthesia unit with a new onset of sinus tachycardia and a heart rate of 118 beats per minute. To which reasons does the nurse relate the increased heart rate? Select all that apply.

Fever Blood loss Anxiety

Which nursing intervention is required to prepare a client with cardiac dysrhythmia for an elective electrical cardioversion?

Instruct the client to restrict food and oral intake

A nursing instructor is reviewing the parts of an EKG strip with a group of students. One student asks about the names of all the EKG cardiac complex parts. Which of the following items are considered a part of the cardiac complex on an EKG strip? Choose all that apply.

P wave P-R interval T wave

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker?

Pacer rate

The nurse analyzes the electrocardiogram (ECG) tracing of a client newly admitted to the cardiac step-down unit with a diagnosis of chest pain. Which finding indicates the need for follow-up?

QT interval that is 0. 46 seconds long

A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?

Spike" on the rhythm strip

A client with heart failure asks the nurse how dobutamine affects the body's circulation. What is the nurse's best response?

The medication increases the force of the myocardial contraction.

A client has been diagnosed with atrial fibrillation and has been prescribed warfarin therapy. What should the nurse prioritize when providing health education to the client?

The need to have regular blood levels drawn

The nurse documents that a client is having a normal sinus rhythm. What characteristics of this rhythm has the nurse assessed?

The sinoatrial (SA) node initiates the impulse.

The nurse knows which heart rhythm occurs when the atrial and ventricular rhythms are both regular, but independent of each other?

Third-degree atrioventricular (AV) heart block

A patient who had a myocardial infarction is experiencing severe chest pain and alerts the nurse. The nurse begins the assessment but suddenly the patient becomes unresponsive, no pulse, with the monitor showing a rapid, disorganized ventricular rhythm. What does the nurse interpret this rhythm to be?

Ventricular fibrillation

The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. What is the priority nursing intervention for the client?

alerting the healthcare provider of the third-degree heart block

A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to

avoid caffeinated beverages.

A client's Holter monitor strip reveals a heart rate with normal conduction but with a rate consistently above 105 beats/minute. What other conditions can cause this response in a healthy heart?

fever shock strenuous exercise

A client asks the nurse what causes the heart to be an effective pump. The nurse informs the client that this is due to the:

inherent rhythmicity of cardiac muscle tissue.

A client's electrocardiogram reveals an irregular rhythm of 75 bpm with a normal QRS and P wave. The nurse who is caring for the client should anticipate:

no immediate treatment.