Bio 300 Chapter 28: Disorders of Cardiac Conduction and Rhythm coursepoint
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 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 nurse is caring for a client with persistent atrial fibrillation (AF) unresponsive to antiarrhythmic therapy. Prior to an elective cardioversion, the nurse anticipates which intervention?
Administration of anticoagulants
A nurse is caring for a client with persistent atrial fibrillation. Which intervention is the priority?
Assessing for shortness of breath or changes in level of consciousness
Which antiarrhythmic medication works by blunting the effect of sympathetic nervous system stimulation on the heart?
Beta-blockers, such as metoprolol
A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take?
Defibrillate the client
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
Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity?
Inherent spontaneous action-potential
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 respiration
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.
Considering the PQRST complex of an electrocardiogram (ECG), which letter designation represents atrial depolarization?
P wave
A client experiencing a sinus arrest would demonstrate which symptom or finding?
Prolonged periods of asystole demonstrated on an electrocardiogram
An intensive care nurse caring for a client who is diagnosed with an anterior wall myocardial infarction (MI) notes frequent premature ventricular complexes on the ECG monitor and is concerned the client could develop a lethal dysrhythmia if one of the premature ventricular complexes fires on which phase of the cardiac action potential?
Relative refractory period ends
While a 60-year-old client is being assessed by the healthcare provider for reports of palpitations, dizziness, and near syncope, the ECG monitor displays intermittent changes in heart rate from the mid-50s to the mid-120s. P waves are present, although not before all QRS complexes. Which dysrhythmia does the health care provider suspect?
Sick sinus syndrome
A 28-year-old marathon runner comes to the clinic to obtain a physical exam for a new job. The nurse assesses a regular pulse rate of 52 beats per minute (bpm). Which common dysrhythmia is the nurse aware this client most likely has related to maintaining a large stroke volume?
Sinus bradycardia
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 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
Which dysrhythmia is considered to be the most fatal and requires immediate treatment?
Ventricular fibrillation
Which client will the nurse prioritize to assess first?
client with sinus arrest
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.
