patho cardio hw
ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this?
Most ECG-detected ischemic events are clinically silent.
A client is visiting the primary physician and appears extremely nervous. The intake nurse does his vital signs and notes an increase in both his heart rate and blood pressure. In an effort to better understand the client's presenting signs and symptoms the nurse asks the client about his concerns and the client states that the person who performed his pre-visit told him that he had a dysrhythmia. Which is the most therapeutic response about cardiac dysrhythmias that the nurse can make?
They can occur in diseased or healthy hearts.
A client has been diagnosed with Stokes-Adams attacks and has been having "dizziness and fainting spells." Which rhythm does the nurse expect to observe on the monitor?
Third-degree heart block
Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator?
Transcutaneous
Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)?
Beta-adrenergic blockers
The nurse explains to a client with a history of unstable angina undergoing knee replacement surgery that it is important to monitor the cardiac rhythms to ensure early detection of which potential complication? Select all that apply.
Cardiac muscle ischemia Tachyarrhythmias Bradyarrhythmias Irregular rhythms
Respiratory sinus dysrhythmia is considered a more optimal rhythm than a rhythm where all RR intervals are equal. In respiratory sinus dysrhythmia, what is the variation in cardiac cycles related to?
Intrathoracic pressure changes that occur with respiratio
The nurse assesses the electrocardiogram for depolarization of the atria. What portion of the ECG will the nurse be assessing?
P wave above the baseline
What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?
SA node - AV node - bundle of His - bundle branches - Purkinje fibers
What cardiac problems is a Holter monitor useful in documenting? Select all that apply.
ST-segment changes Conduction abnormalities
A 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of:
Sympathetic nervous system
A client with a history of angina presents with uncharacteristic chest pain. The subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which aspects of the cardiac cycle?
Ventricular depolarization
An 80-year-old male client arrives for his yearly physical without any complaints, and following the checkup the physician explains that he has noted atrial fibrillation (AF) on the client's ECG. Before the physician can explain the disorder, the client becomes very upset and states he thinks he is going to die. The physician explains that atrial fibrillation involves the top chambers of the heart and that:
many people live with atrial fibrillation without even knowing they have it.
Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization?
p wave
An intensive care unit nurse is caring for a client who suffered a myocardial infarction involving the anterior wall, and notes a change in the cardiac rhythm. The rhythm has a PR interval that does not change, but there are twice as many P waves as there are R waves. The nurse prepares for a temporary pacemaker insertion because the client has developed:
second-degree, type 2 AV block.
A nurse is caring for a client with an average heart rate of 56 beats/min. The client has no adverse symptoms associated with this heart rate and is receiving no treatment. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?
"Avoid bearing down while having a bowel movement."
A client who will be undergoing a Holter monitor examination would be given which instruction?
"Keep a diary of your activities and symptoms throughout the examination."
The nurse is assisting a client who had a myocardial infarction 2 days ago during a bath. The client suddenly lost consciousness and the nurse was unable to feel a pulse. Cardiopulmonary resuscitation was begun and the client was connected to the monitor with a gross disorganization without identifiable waveforms or intervals observed. What is a priority intervention at this time?
Immediate defibrillation
A client is scheduled to have a Holter monitor for 48 hours to detect disturbances in conduction. Which action is important for the nurse to tell the client to ensure accuracy in correlating dysrhythmias with symptoms?
It is important to keep a diary of activities and symptoms.
A client is seen in the emergency department complaining of chest discomfort, productive cough, and a fever of over 101°F (38.3°C) for 3 days. The nurse performs an electrocardiogram and observes a rate of 110 beats per minute (bpm) with a normal P wave and a PR interval of 0.12 second preceding each QRS complex. What does the nurse determine the rhythm to be?
Sinus tachycardia
A client with a 2-week history of hyperthyroidism due to a virus is admitted for nonemergent cardioversion. The client states that she has been experiencing intermittent episodes of palpitations over the past week along with shortness of breath and fatigue. The nurse attaches the client to a cardiac monitor and notes that the client is in normal sinus rhythm with frequent episodes of atrial fibrillation. The nurse anticipates which of the following to be ordered prior to the cardioversion to avoid a possible stroke?
Transesophageal echocardiography
A client arrives at the emergency room with dizziness and a near syncopal episode. Vital signs include a heart rate of 46 beats/min and blood pressure of 86/50 mm Hg. The cardiac monitors show regular rhythm as above. The client states the health care provider has been running blood work to rule out hypothyroidism. Based on the rhythm, what does the nurse report the client has?
symptomatic bradyarrhythmia
