1340 PU ch 26: Caring for Clients with Cardiac Dysrhythmias

The nurse is caring for a client with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the client's most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best interpret this finding?

Recognize this as a therapeutic goal of the procedure.

The nurse is providing discharge instructions for a client with a newly implanted cardiac defibrillator. What statement made by the client indicates the need for further teaching?

"I will report if I feel lightheaded and dizzy at my next doctor's appointment."

The nursing student asks the nurse to describe the difference between sinus rhythm and sinus bradycardia on the electrocardiogram strip. What is the nurse's best reply?

"The only difference is the heart rate."

The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response?

"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."

The nurse is working on a telemetry unit, caring for a client who develops dizziness and a second-degree heart block, Mobitz Type 1. What will be the initial nursing intervention?

Administer an IV bolus of atropine.

Which dysrhythmia has an atrial rate between 250 and 400, with saw-toothed P waves?

Atrial flutter

A nurse is caring for a client who's experiencing sinus bradycardia with a pulse rate of 40 beats/minute. The client's blood pressure is 80/50 mm Hg and the client reports dizziness. Which medication does the nurse anticipate administering to treat bradycardia?

Atropine

The nurse is planning discharge teaching for a client with a newly inserted permanent pacemaker. What is the priority teaching point for this client?

Avoid exposure to strong electromagnetic fields

The nurse is providing discharge instructions to a client after a permanent pacemaker insertion. Which safety precaution will the nurse communicate to the client?

Avoid undergoing magnetic resonance imaging (MRI).

A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next?

Begin cardiopulmonary resuscitation

The nurse in the intensive care unit (ICU) hears an alarm sound in the patient's room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse?

Begin cardiopulmonary resuscitation (CPR)

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?

Bleeding at the implantation site

The nurse is caring for a client who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment?

Cardiac monitoring

The nurse is caring for a client who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output?

Changes in level of consciousness

A nurse is caring for a client who is exhibiting ventricular tachycardia (VT). Because the client is pulseless, the nurse should prepare for what intervention?

Defibrillation

The nurse is observing the monitor of a patient with a first-degree atrioventricular (AV) block. What is the nurse aware characterizes this block?

Delayed conduction, producing a prolonged PR interval

A client has been living with an internal, fixed-rate pacemaker. When checking the client's readings on a cardiac monitor the nurse notices an absence of spikes. What should the nurse do?

Double-check the monitoring equipment.

The nurse is caring for a client who is in the recovery room following the implantation of an ICD. The client has developed ventricular tachycardia (VT). What should the nurse assess and document?

ECG to compare time of onset of VT and onset of device's shock

The nurse is assessing a client who had a pacemaker implanted 4 weeks ago. During the client's most recent follow-up appointment, the nurse identifies data that suggest the client may be socially isolated and depressed. What nursing diagnosis is suggested by these data?

Ineffective coping related to pacemaker implantation

A healthy adult client is seeing a health care provider for an annual physical examination. While the nurse is taking the client's vital signs, the client states, "Occasionally, my heart skips a beat." The nurse believes that the client is experiencing what condition?

Premature atrial complex

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the client's heart?

T wave

A client has been diagnosed with atrial fibrillation and has been prescribed warfarin therapy. What should the nurse prioritize when providing health education to the client?

The need to have regular blood levels drawn

A patient has been admitted to the unit for an electrophysiology (EP) study. For what is an electrophysiology study primarily performed?

To diagnose the dysrhythmia

A client tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the client is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the client to

avoid caffeinated beverages.

A client reports light-headedness, chest pain, and shortness of breath. They physician orders tests to ascertain what is causing the client's problems. Which test is used to identify cardiac rhythms?

electrocardiogram

The nurse assesses a client with a heart rate of 120 beats per minute. What are the known causes of sinus tachycardia?

hypovolemia

A client asks the nurse what causes the heart to be an effective pump. The nurse informs the client that this is due to the:

inherent rhythmicity of cardiac muscle tissue.