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Idioventricular rhythm occurs when the impulse starts in the conduction system below the AV node. The nurse would expect which of the following atrial rates to correlate with an idioventricular rhythm?

20 to 40

The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?

Fluttering

The nursing instructor is discussing pacemakers with her clinical group. One of the students is caring for a client with a transvenous pacemaker. One of the students asks why this client has a transvenous pacemaker. What would be the instructor's best response?

"A transvenous pacemaker is used to manage transient bradydysrhythmias like those that occur during acute MIs."

The nurse is caring for a client who is being discharged after insertion of a permanent pacemaker. Which question by the client indicates a need for clarification?

"I should ask for a handheld device search when I go through airport security."

A nurse is performing discharge teaching with a client who has an implantable cardioverter defibrillator (ICD) placed. Which client statement indicates effective teaching?

"I'll keep a log of each time my ICD discharges."

The nurse receives a telephone call from a client with an implanted pacemaker who reports that his pulse is 68 beats per minute, but his pacemaker rate is set at 72 beats per minute. The best response by the nurse is which of the following?

"Please come to the clinic right away so that we may interrogate the pacemaker to see if it is malfunctioning."

The nurse is caring for a client who had a permanent pacemaker surgically placed yesterday and is now ready for discharge. Which statement made by the client indicates the need for more education.

"We will be getting rid of our microwave oven so it will not affect my pacemaker."

A client has had a pacemaker implanted and the nurse will begin client education upon the client becoming alert. Which postimplantation instructions must be provided to the client with a permanent pacemaker?

Avoid sources of electrical interference

Two clients in cardiac rehabilitation are discussing the differences between scheduled cardioversion and unexpected defibrillation. Which statement does the nurse note is not correct?

Cardioversion uses more electrical energy than defibrillation

A pacemaker is the treatment of choice for what cardiac dysrhythmia?

Complete heart block

The nurse is asked to explain ventricular bigeminy to a patient. The nurse explains that it is a conduction defect in which:

Every other complex is a PVC.

A patient is prescribed Quinidex for treatment of moderate depression of depolarization. The nurse knows to assess for the drugs' effectiveness, which can be evidenced by which of the following?

Decrease in cardiac contractility

After evaluating a client for hypertension, a physician orders atenolol (Tenormin), 50 mg P.O. daily. Which therapeutic effect should atenolol have?

Decreased cardiac output and decreased systolic and diastolic blood pressure

A nurse evaluates a client with a temporary pacemaker. The client's ECG tracing shows each P wave followed by the pacing spike. What is the nurse's best response?

Document the findings and continue to monitor the client

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 preparing a patient for upcoming electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia. Which of the following information should the nurse include

During the procedure, the arrhythmia will be reproduced under controlled conditions.

The nurse is assessing a client with mitral regurgitation. The nurse expects to note which of the following findings in this client?

Dyspnea, fatigue, and weakness

You are caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?

Elective cardioversion

Your client has been diagnosed with an atrial dysrhythmia. The client has come to the clinic for a follow-up appointment and to talk with the physician about options to stop this dysrhythmia. What would be a procedure used to treat this client?

Elective electrical cardioversion

What is the treatment of choice for ventricular fibrillation?

Immediate bystander CPR

Which nursing intervention is required to prepare a client with cardiac dysrhythmia for an elective electrical cardioversion?

Instruct the client to restrict food and oral intake

A patient is 2 days postoperative after having a permanent pacemaker inserted. The nurse observes that the patient is having continuous hiccups as the patient states, "I thought this was normal." What does the nurse understand is occurring with this patient?

Lead wire dislodgement

Your client has just been prescribed Pronestyl for their dysrhythmia. What would you teach this client about the side effects?

Lupus-like syndrome

Which nursing intervention must a nurse perform when administering prescribed vasopressors to a client with a cardiac dysrhythmia?

Monitor vital signs and cardiac rhythm

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker?

Pacer rate

A client admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which electrocardiographic (ECG) characteristic is commonly associated with this laboratory finding?

Peaked T waves

The nurse takes a preoperative ECG on a 48-year-old patient. She notices that there is a longer than normal distance between right ventricular depolarization and repolarization. She documents the strip finding and notifies the surgeon. Her conclusion was based on an abnormality in which of the following?

QT interval

The nurse analayzes the electrocardiogram (ECG) tracing of a client newly admitted to the cardiac step-down unit with a diagnosis of chest pain. Which finding indicates the need for follow-up

QT interval that is 0. 46 seconds long

You are an operating room nurse caring for a client who is having a pacemaker implanted. The physician has requested a demand mode pacemaker for this client. What is this type of pacemaker?

Self-activated

The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. The correct response would be which of the following?

Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers

The registered nurse reviewed the patient's q4h vital signs recorded by the LPN. He noticed a consistent pattern of heart rate recordings between 48 and 58 bpm over a 24-hour period of time. The nurse, aware that bradycardia can be a side-effect of medications, checked the patient's electronic health record. Select the medication that might cause bradycardia

Tenormin

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 client has an irregular heart rate of around 100 beats/minute and a significant pulse deficit. What component of the client's history would produce such symptoms?

atrial fibrillation

Which is not a likely origination point for cardiac dysrhythmias?

bundle of His

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

Premature ventricular contractions (PVCs) are considered precursors of ventricular tachycardia (VT) when they

occur at a rate of more than six per minute