Pre&Post Simulation Quiz - Liling Zhao

The nurse caring for Liling Zhao has received the following order: 'Administer intravenous (IV) potassium chloride 10 mEq in 100 mL 0.9% sodium chloride over 1 hour times 2 doses.' Which intervention(s) is important for the nurse to implement when administering this medication? (Select all that apply.)

Administer via an IV pump Ensure continuous cardiac monitoring is in place Assess peripheral IV site for blood return prior to administering Monitor urine output throughout infusion Slow the rate of infusion if the patient complains of burning at the IV site

The patient is being discharged after an implantable cardioverter defibrillator (ICD) insertion. Which statement by the patient indicates the nurse needs to include further instruction?

"I am so glad that I won't need to take my medications anymore."

The nursing student is caring for a patient with an implantable pacemaker that is described as dual chamber/dual demand (DDD). Which statement by the student requires further education by the instructor?

"The pacemaker will overdrive a tachycardia event in the ventricle."

Liling Zhao, a patient who has multiple shocks with an internal cardioverter defibrillator (ICD) over the last 24 hours, is crying and states, 'I can't believe this keeps happening to me'; her problem is (Choose Answer..), which is causing (Choose Answer..).

feeling helpless poor coping

The nurse is caring for a patient who has been taking hydrochlorothiazide for 2 weeks. Which adverse reaction would the nurse be alert for?

Hypokalemia

The nurse is with Liling Zhao when her internal cardioverter defibrillator (ICD) delivers a shock, causing her to yell out in pain. After the shock, the nurse performs an assessment and finds that the patient has a blood pressure of 110/70 mm Hg and a regular pulse of 60 beats per minute. She is crying and tells the nurse, 'I think I am going to die.' The rhythm strip analysis shows a wide QRS at a rate of about 180 beats per minute prior to the shock and a return to 100% pacing at 60 beats per minute. The nurse would notify the health care provider of which significant finding(s)? (Select all that apply.)

The patient was stable after the ICD fired. The patient was in pain when the ICD fired. The rhythm when the ICD fired was a fast rhythm The pacemaker resumed at the assigned rate. The patient thinks she is dying.

Liling Zhao states, 'I was better off before they put this device in me. I just don't know how much longer I can go on with this.' Which strategy(ies) would the nurse use to help the patient cope with the feelings of helplessness? (Select all that apply.)

Encourage participation in support groups, when discharged Describe activities the patient enjoys that she can still participate in Educate about stress-reduction activities Discuss how she is feeling with the health care team Remind the patient that anger and fear are normal responses Assist with developing realistic goals for activities

The nurse is reviewing the history, assessment, and laboratory findings for Liling Zhao, a patient with a combination pacemaker and internal cardioverter defibrillator (ICD) that has been firing more frequently than usual. In reviewing the history, which finding(s) is significant? (Select all that apply.)

Hydrochlorothiazide initiated Potassium level 2.8 mEq/L

The nurse is admitting a patient with hypokalemia. Which clinical manifestation(s) would the nurse be alert for? (Select all that apply.)

Muscle weakness Life-threatening dysrhythmias Paresthesia Hypoactive reflexes

The patient with an implantable cardioverter defibrillator (ICD) has experienced several shocks over the previous 24 hours. The patient is waiting to be evaluated by a specialist. When caring for this patient, what would the nurse be prepared for?

Recognize and support the patient's emotional health

The nurse is evaluating a patient with new onset cardiovascular disease with a prolonged QT interval. The patient has no apparent risk factors. Which genetic abnormality can cause prolonged QT syndrome?

Romano-Ward syndrome

The nurse hears a shout of "Ow!" from the room of a patient with a dual pacemaker and implantable cardioverter defibrillator (ICD). The cardiac monitor shows a rapid, wide rhythm at a rate of 160 beats per minute followed by a shock, a brief pause, and a return to a rate of 60 beats per minute. How does the nurse analyze this finding?

The ICD is responding appropriately.

It has been 24 hours since Liling Zhao has received any shocks from the device. The nurse is preparing to discharge her. Which finding(s) indicates the treatment has been effective? (Select all that apply.)

The cardiac monitor reveals a 100% paced rhythm at a rate of 60 beats per minute. There have been no premature ventricular conduction (PVC) beats identified. The serum potassium level is 3.8 mEq/L on the morning labs. The patient's urine output has been 40 mL/hr overnight. The patient reports pain at 0 out of 10 since last night.

A patient is preparing to get an implantable cardioverter defibrillator (ICD). Which point(s) would the nurse include when teaching the patient? (Select all that apply.)

The defibrillator is designed to respond to specific criteria of life-threatening cardiac rhythms. The battery pack will be underneath your skin, usually in your upper chest. The battery life is usually about 9 years. The ICD will be evaluated remotely to report the number and frequency of shocks delivered. The device may need to be reprogrammed if it misfires.