ECG ati

A nurse is reinforcing teaching with a client who is scheduled for an exercise ECG stress test. Which of the following comments should indicate to the nurse that the client requires further instructions?

"I will expect to feel chest pain during this test." Rationale: The client should report any chest pain, dizziness, or dyspnea that occurs during the test because this is a manifestation of myocardial ischemia and the test should be stopped.

A nurse is preparing to perform a 12-lead electrocardiogram (ECG). Which of the following instructions should the nurse provide to the client?

"Try to remain still once I have attached the gel pads." Rationale: The nurse should stress the importance of lying still during the ECG to prevent artifact from occurring and allow for clear results when interpreted by the provider.

A nurse is reinforcing teaching with a client who is scheduled for an ECG. Which of the following instructions should the nurse include?

"You will need to lie still on your left side during this test." Rationale: The client will need to lie still on his left side or supine during the ECG.

A nurse is planning to perform an electrocardiogram (ECG) for a client who has a history of coronary heart disease. Which of the following actions should the nurse take? (Select all that apply.)

- Inspect the electrode pads. - Use alcohol to wipe the skin before placing the electrodes. - Instruct the client to breath normally. Rationale:Keep the client NPO after midnight is incorrect. The client will not receive anesthesia for to the test so he does not need to follow a food or fluid restriction prior to the test. Inspect the electrode pads is correct. The nurse should inspect the electrode pads to check that the gel is present because the gel is necessary to promote electrical conduction between the skin and the electrodes. Use alcohol to wipe the skin before placing the electrodes is correct. The nurse should wipe the skin where she will place the electrodes to ensure the skin is free of oils and other matter. Instruct the client not to talk is correct. The nurse should instruct the client to lie quietly, not talk, or move to prevent the recording of artifact. Administer an analgesic prior to the procedure is incorrect. The client does not need to receive an analgesic prior to the test because the test is noninvasive and does cause any discomfort.

A nurse is reinforcing teaching with a newly licensed nurse about reading a client's ECG tracing. The nurse should include in the teaching that the P wave represents which of the following cardiac electrical activities?

Atrial depolarization. Rationale: The P wave represents atrial depolarization, typically initiated in the sinoatrial node.

A nurse is assisting with collecting data on a client who is on a continuous ECG monitor. The client's ECG tracing shows no identifiable P waves and an irregular ventricular rate. The nurse should recognize the client is experiencing which of the following cardiac dysrhythmias?

Atrial fibrillation Rationale: Atrial fibrillation is a supraventricular rhythm that is characterized by no identifiable P waves and a variable ventricular rate.

A nurse is assisting with the care of a client in the emergency department and reports severe radiating chest pain and shortness of breath. The client appears restless, frightened, and slightly cyanotic. The provider prescribes oxygen by nasal cannula at 4 L/min stat, cardiac enzyme levels, IV fluids, and a 12-lead ECG. Which of the following actions should the nurse take first?

Initiate oxygen therapy. Rationale: The greatest risk to the client's safety is myocardial ischemia; therefore, the first action the nurse should take is initiate oxygen therapy.

A nurse is reinforcing teaching with a newly licensed nurse about reading a client's ECG tracing. The nurse should include in the teaching that which of the following ECG components represent the time it takes for ventricular depolarization and repolarization?

Qt Interval Rationale: The QT interval reflects the time it takes for ventricular depolarization and repolarization. The nurse should measure the QT interval from the start of the QRS complex to the end of the T wave.

A nurse is caring for a client who has a serum potassium level of 5.5 mEq/L. The provider prescribes polystyrene sulfonate. Which of the following ECG results should indicate to the nurse that the medication has been effective?

Reduction of T wave amplitude Rationale: The nurse should identify that the polystyrene sulfonate should bring the potassium level back to the expected reference range. Hyperkalemia causes peaked T waves and a widened QRS on ECG, so resolution of the potassium imbalance should restore these ECG changes to baseline.

A nurse is assisting with the care of a client who was admitted to the telemetry unit after he experienced chest pain, dyspnea and diaphoresis. Which of the following ECG findings is a manifestation of acute myocardial infarction?

The ST segment is above the isoelectric line. Rationale: Myocardial infarction is classified as ST elevation (MI STEMI) or non-ST elevation (MI NSTEMI). ST elevation is a manifestation of MI STEMI.