Rhythms and Dysrhythmias

A patient is to have synchronized cardioversion for treatment of atrial flutter. He has received Heparin 500 units subcutaneously. Which intervention should now be performed?

Sedate the patient with Versed 2 mg IV push per protocol.

Prior to discharge from the Emergency Department, the nurse prints a rhythm strip on a patient and notices that the P wave cannot be detected and the QRS complex is 0.24 seconds. This is a change in the patient's condition. What is the best action for the nurse to take?

Notify the physician

When auscultating the apical pulse of a client who has atrial fibrillation, the nurse would expect to hear a rhythm that is characterized by: The presence of occasional coupled beats Long pauses in an otherwise regular rhythm A continuous and totally unpredictable irregularity Slow but strong and regular beats

A continuous and totally unpredicatable irregularity

A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: Premature ventricular contractions Ventricular tachycardia Ventricular fibrillation Sinus tachycardia

A nurse is watching the cardiac monitor and notices that the rhythm suddenly changes. There are no P waves, the QRS complexes are wide, and the ventricular rate is regular but over 100. The nurse determines that the client is experiencing: Premature ventricular contractions Ventricular tachycardia Ventricular fibrillation Sinus tachycardia

While caring for a client who has sustained an MI, the nurse notes eight PVCs in one minute on the cardiac monitor. The client is receiving an IV infusion of D5W and oxygen at 2 L/minute. The nurse's first course of action should be to: Increase the IV infusion rate Notify the physician promptly Increase the oxygen concentration Administer a prescribed analgesic

Notify the physician

A nurse is assessing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 second, and QRS complexes measure 0.06 second. The overall heart rate is 64 beats per minute. The nurse assesses the cardiac rhythm as:

Normal sinus rhythm

The nurse observes V-tach on the monitor. The patient is pulseless and apneic. The nurse should immediatley?

Open the airway and begin CPR

A nurse is viewing the cardiac monitor in a client's room and notes that the client has just gone into ventricular tachycardia. The client is awake and alert and has good skin color. The nurse would prepare to do which of the following? Immediately defibrillate Prepare for pacemaker insertion Administer amiodarone (Cordarone) intravenously Administer epinephrine (Adrenaline) intravenously

Administer amiodarone

What is the first choice for treatment with a patient who has ventricular tachycardia and has a pulse?

Amiodarone

When a patient has long-term atrial fibrillation, the nurse would expect to include which drug in the plan of care to minimize the greatest risk that is commonly associated with atrial fibrillation?

Anticoagulants

A nurse is watching the cardiac monitor, and a client's rhythm suddenly changes. There are no P waves; instead there are wavy lines. The QRS complexes measure 0.08 second, but they are irregular, with a rate of 120 beats a minute. The nurse interprets this rhythm as:

Atrial Fibrillation

A client is having frequent premature ventricular contractions. A nurse would place priority on assessment of which of the following items? Blood pressure and peripheral perfusion Sensation of palpitations Causative factors such as caffeine Precipitating factors such as infection

Blood pressure and peripheral perfusion

When ventricular fibrillation occurs in a CCU, the first person reaching the client should: Administer oxygen Defibrillate the client Initiate CPR Administer sodium bicarbonate intravenously

Defibrillate the client

A 65-year-old female patient comes to the Emergency Department with complaints of chest pain and shortness of breath. Her BP is 87/60. After being placed on the monitor it shows that she is in first degree heart block with bradycardia. What nursing intervention should take place?

Give her atropine 1 mg IVP

A client has developed atrial fibrillation, which a ventricular rate of 150 beats per minute. A nurse assesses the client for: Hypotension and dizziness Nausea and vomiting Hypertension and headache Flat neck veins

Hypotension and dizziness

A patient found pulseless and unconscious is placed on the monitor that shows v-fib rhythm. What should the nurse do next?

Immediately start CPR and call a code.

The adaptations of a client with complete heart block would most likely include: Nausea and vertigo Flushing and slurred speech Cephalalgia and blurred vision Syncope and slow ventricular rate

Syncope and slow ventricular rate

What criteria should the nurse use to determine normal sinus rhythm for a client on a cardiac monitor? Check all that apply. The RR intervals are relatively consistent One P wave precedes each QRS complex Four to eight complexes occur in a 6 second strip The ST segment is higher than the PR interval

The RR intervals are relatively consistent One P wave precedes each qrs complex

A 21-year-old female is seen in the Emergency Department for vomiting and diarrhea for 3 days. Her BP is 94/64 and her EKG rhythm is Sinus tachycardia. The best action for the nurse to take initially is to:

Treat the underlying problem: the dehydratoin and vomiting. IV bolus of fluids

A nurse notes that a client with sinus rhythm has a premature ventricular contraction that falls on the T wave of the preceding beat. The client's rhythm suddenly changes to one with no P waves or definable QRS complexes. Instead there are coarse wavy lines of varying amplitude. The nurse assesses this rhythm to be:

Ventricular fibrillation

A client with a bundle branch block is on a cardiac monitor. The nurse should expect to observe: Sagging ST segments Absence of P wave configurations Inverted T waves following each QRS complex Widening of QRS complexes to 0.12 second or greater

Widening of QRS complexes to 0.12 seconds or greater

A 38-year-old female is brought to the Emergency Department with complaints of her "heart beating out of her chest". She is diaphoretic, tachypneic and her BP is 70/40. The cardiac monitor shows supraventricular tachycardia. Valsalva maneuvers and three doses of Adenosine have not been successful. The nurse should immediately:

prepare the patient for synchronized cardioversion.