cardiology chapter 22

The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication? A) Epinephrine 1 mg IV push B) Lidocaine 100 mg IV push C) Amiodarone 300 mg IV push D) Sodium bicarbonate 1 amp IV push

A) Epinephrine 1 mg IV push

the nurse is caring for a client who has had an ECG. The nurse noticed that leads I,II, and III differ from one another on the cardiac rhythm strip. how should the nurse best respond? A) recognize that the view of the electrical current changes in relation to the lead placement. B) recognize that the electrophysiological conduction of the heart differs with lead placement. C) inform the technician that the ECG equipment has malfunctioned. D) Inform the healthcare provider that the client is experiencing a new onset of dysrhythmia.

A) recognize that the view of the electrical current changes in relation to the lead placement.

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patients heart? A) P wave B) T wave C) U wave D) QRS complex

B) T wave

A client converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and diltiazem are given. The nurse caring for the client understands that the treatment has what main goal? A. Decrease SA node conduction. B. Control ventricular heart rate. C. Improve oxygenation. D. Maintain anticoagulation.

B. Control ventricular heart rate.

An adult client with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show? A) PP interval and RR interval are irregular. B) PP interval is equal to RR interval. C) Fewer QRS complexes than P waves D) PR interval is constant.

C) Fewer QRS complexes than P waves

A 62-year-old client with A-Fib and a CHA2DS-VASc score of 3 is being discharged home today. Based on this score, which additional medications or medications would be prescribed for this client? A) no antithrombotic therapy, oral anticoagulant, or aspirin B) low molecular weight heparin or intravenous heparin c) Warfarin, direct thrombin inhibitor, or factor Xa inhibitor D) antiarrhythmic agents and aspirin

C) warfarin, direct thrombin inhibitor, or Factor Xa inhibitor.

a client is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. the nurse caring for this client is aware the medication of choice for the treatment of this dysrhythmia is the administration of atropine. what guidelines will the nurse follow when administering atropine? a) administer atropine 0.5mg as an IV bolus every 3 to 5 mins to a maximum of 3.0mg. b) administer atropine as a continuous infusion until symptoms resolve. c) administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours. d) administer atropine 1.0mg sublingually.

a) admin atropine 0.5mg as an IV bolus every 3 to 5 mins to a maximum of 3.0mg.

a nurse is caring for a client who is exhibiting ventricular tachycardia. because the client is pulseless, the nurse should prepare for what intervention? a) defibrillation b) ECG monitoring c) implantation of a cardioverter defibrillator d) angioplasty

a) defibrillation

the nurse is caring for an adult client who has gone into ventricular fibrillation. when assisting with defibrillating the client, what must the nurse do? a) maintain firm contact between paddles and the client's skin. b) apply a layer of water as a conducting agent. d) call "all clear" once before discharging the defibrillator. c) ensure the defibrillator is in the sync mode.

a) maintain firm contact between paddles and the client's skin.

a client who is a candidate for an implantable cardioverter defibrillator asks the nurse about the purpose of this device. what would be the nurse's best response? a) to detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia. b) to detect and treat bradycardia, which is an excessively slow heart rate c) to detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently d) to shock your heart if you have a heart attack at home.

a) to detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia.

a client the nurse is caring for has a permanent pacemaker implanted, with the identification code beginning with VVI. what does this indicate? a) ventricular paced, ventricular sensed, inhibited b) variable paced, ventricular sensed, inhibited c) ventricular sensed, ventricular situated, implanted d) variable sensed, variable paced, inhibited.

a) ventricular paced, ventricular sensed, inhibited

A client has returned to the cardiac care unit after having a permanent pacemaker implantation. for which potential complication should the nurse most closely assess this client? a) chest pain b) bleeding at the implantation site c) malignant hyperthermia d) bradycardia

b) bleeding at the implantation site

The nursing educator is presenting a case study of an adult client who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG? A) P wave B) T wave C) QRS complex D) U wave

c) QRS complex

the nurse is planning discharge teaching for a client with a newly inserted permanent pacemaker. what is the priority teaching point for this client? a) start lifting the arm above the shoulder right away to prevent chest wall adhesion. b) avoid cooking with a microwave oven. c) avoid exposure to strong electromagnetic fields d) avoid walking through store and library antitheft devices.

c) avoid exposure to strong electromagnetic fields

the nurse is caring for a client who has just had an implantable cardioverter defibrillator placed. what is the priority area for the nurse's assessment? a) assessing the client's mobility b) facilitating transthoracic echocardiography c) vigilant monitoring of the client's ECG d) close monitoring of the client's peripheral perfusion

c) vigilant monitoring of the client's ECG