Week #12: Dysrhythmias

The monitor technician informs the nurse that the client has started having premature ventricular contractions every other beat. Which is the priority nursing action? a. activate the rapid response team b. assess the client's orientation and vital signs c. call the physician d. administer a bolus of lidocaine

b. assess the client's orientation and vital signs check the patient before you treat the strip

A client is given amiodarone in the ED for a dysrhythmia. Which of the following indicates the drug is having the desired effect? a. the ventricular rate is increasing b. the number of premature ventricular contractions is decreasing c. the absent pulse is now palpable d. the fine ventricular fibrillation changes to coarse ventricular fibrillation

b. the number of premature ventricular contractions is decreasing We are giving it to decrease PVCs

Following an MI, a client develops an arrhythmia and requires a continuous infusion of lidocaine. To monitor the effectiveness of the intervention, the nurse should focus primarily on the client's: a. ECG b. lidocaine level c. troponin level d. blood pressure

a. ECG

The nurse is administering adenosine to a client with supra ventricular tachycardia. What is the expected therapeutic response? a. a short period of asystole b. a brief episode of ventricular tachycardia c. an increase in BP d. brief feeling of numbness & tingling of extremities

a. a short period of asystole

A client is admitted to the telemetry unit with atrial fibrillation. What is the appropriate action of the nurse? SATA a. administer warfarin b. application of SCDs c. continuous cardiac monitoring d. monitor for decreased deep tendon reflexes e. assess for changes in level of conciousness

a. administer warfarin b. application of SCDs c. continuous cardiac monitoring d. monitor for decreased deep tendon reflexes e. assess for changes in level of conciousness

A client wearing a continuous cardiac monitor suddenly sets off an alarm. A nurse sees no electrocardiograph complexes on the screen. Which is the priority action of the nurse? a. call a code b. call the HCP c. check the client's status & lead placement d. press the recorder button on the electrocardiogram console

c. check the client's status & lead placement check the patient before you treat the strip!

The nurse caring for a client on the cardiac unit notices that the client's cardiac monitor shows ventricular fibrillation. What is the priority action by the nurse? a. admin digoxin b. insertion of an IV line c. immediate defibrillation d. scheduling a pacemaker insertion

c. immediate defibrillation they are dead- already gone! The other interventions won't do anything for this pt.

A nurse is caring for a client who is experiencing sinus bradycardia with a pulse rate of 40 bpm. His BP is 80/50 and he complains of dizziness. What is the nurse's priority action? a. administer lidocaine 100mg IV push as ordered b. administer a 500ml bolus of NS c. notify the attending physician d. administer atropine 0.5mg IV push as ordered

d. administer atropine 0.5mg IV push as ordered atropine will increase HR lidocaine will kill them

A client is admitted to the telemetry unit following a ST segment-elevation MI. The electrocardiogram tracing shows a run of sustained ventricular tachycardia. What is the first action that the nurse should take? a. apply the external pacemaker b. begin CPR c. defibrillate the client d. assess the client's airways, breathing, pulses, and LOC

d. assess the client's airways, breathing, pulses, and LOC with V-tach we need to determine if patient has a pulse or not. If pulse- cardiovert If no pulse- defibrillate

A client with chest pain, dyspnea, and an irregular HB comes to the ED. An EEG shows a HR of 110 bpm (sinus tachycardia) with frequent premature ventricular contractions. Shortly after admission, the client has ventricular tachycardia and becomes unresponsive. After successful resuscitation, the client is taken to the ICU. Which nursing diagnosis is the priority at this time? a. fear related to threat of death b. activity intolerance related to decreased cardiac output c. social isolation related to restricted visiting hours in ICU d. ineffective tissue perfusion (cardiopulmonary) related to arrhythmia

d. ineffective tissue perfusion (cardiopulmonary) related to arrhythmia

A patient with a HR of 45 bpm complains of dizziness and has a BP of 82/60. Which action should the nurse take? a. defibrillate the client b. administer digoxin c. continue to monitor the client d. prepare for transcutaneous pacing

d. prepare for transcutaneous pacing bradycardia: give IV atropine or transcutaneous pacing. Digoxin will kill this patient. Slows HR