DYSRHYTHIMAS

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Which lab result for a patient with multifocal premature ventricular contractions (PVCs) is MOST important for the nurse to communicate to the health care provider

serum potassium of 2.9

A patient has a sinus rhythm and a heart rate of 72. The nurse determines that the PR interval is 0.24 seconds what action should the nurse take

document the findings and monitor the patient

A patient has a junctional escape rhythm on the monitor. What heart rate should the nurse expect the patient to have

40 to 60

When analyzing an electrocardiographic (ECG) rhythm strip of a patient with a regular heart rhythm, the nurse counts 30 small blocks fro one R wave to the next. The nurse calculates the patients heart rate as what?

50

A patient is apneic and has no palpable pulses. The heart monitor shows sinus tachycardia rate 132. What actions should the nurse take next?

start cardiopulmonary resuscitation (CPR)

Which action by a nurse caring for a patient after an implantable cardioverter-defib (ICD) insertion indicates a need for more teaching about the care of patients with ICDs?

the nurse encourages the patient to do active range of motion exercises for all extremities

The nurse evaluates that discharge teaching about the management of a new permanent pacemaker has been effective when the patient states

I won't lift the arm on the pacemaker side until I see the health care provider

A patient has ST segment changes that suggest an acute inferior wall myocardial infarction. Which lead would be the MOST useful for monitoring this patient?

II or 12?

what should the nurse measure to determine whether there is a delay in impulse conduction through the patient's ventricles

QRS complex

Which finding from a newly admitted adult patient's electrocardiogram (ECG) requires further investigation by the nurse?

QRS interval of 0.14 seconds

The nurse has received change of shift report about the following patients on the progressive care unit. Which patient should the nurse see FIRST

a patient whose implantable cardioverter-defibillator (ICD) fired twice today and has a dose of amiodarone (cordarone) due

1. When preparing to defibrillate a patient, in which order will the nurse perform the following steps?

a. TURN THE DEFIBRILLATOR ON b. SELECT THE APPROPRIATE ENERGY LEVEL c. PLACE THE HANDS-FREE, MULTIFUNCTION DEFIBRILLATOR PADS ON THE PATIENT'S CHEST d. CHECK THE LOCATION OF OTHER STAFF AND CALL OUT "ALL CLEAR" e. DELIVER THE ELECTRICAL CHARGE

A 20 year old patient has a mandatory electrocardiogram (ECG) before participating on a college soccer team. The patient is found to have sinus bradycardia, rate of 52 and blood pressure of 114/54. The student denies any health problems. What action by the nurse is appropriate?

allow the student to participate on the team

A patient with dilated cardiomyopathy has new onset of atrial fib that has been unresponsive to drug therapy for several day. What topic should the nurse plan to include in patient teaching?

anticoagulation therapy

A patient develops sinus bradycardia at a rate of 32, has a BP of 80/42. And reports feeling faint. Which action should the nurse take?

apply the transcutaneous pacemaker (TCP) pads

A 19yr old student comes to the student health center at the end of the semester stating, "My heart is skipping beats". An electrocardiogram (ECG) shows occasional unifocal premature ventricular contractions (PVCs). What action should the nurse take NEXT?

ask the patient about current stress level and caffeine use

A patient with supraventricular tachycardia who is alert and has a blood pressure of 110/66 is being prepared for cardioversion. Which action should the nurse take?

give a sedative before cardioversion is implemented

A patient on the telemetry unit develops atrial flutter, rate 150, with associated dyspnea and chest pain which action that is included in the agency dysrhythmia protocol should the nurse do first?

give supplemental O2 at 2 to 3 L/min via nasal cannula

A patient's heart monitor shows sinus rhythm, rate 64. The PR interval is 0.18 seconds at 1:00AM, 0.22 seconds at 230PM and 0.28 seconds at 4:00PM. Which action should the nurse take FIRST?

hold the scheduled metoprolol and call the health care provider

After the nurse gives IV atropine to a patient with symptomatic type 1 second degree atrioventricular block (AV), which finding indicates that the drug has been effective?

increases the patients heart rate

Which action by a new RN who is orienting to the telemetry unit indicates a good understanding of the treatment of heart dysrhymias?

injects IV adenosine (adenocard) over 2 seconds for a patient with supra ventricular fibrillation

Which action will the nurse include in the plan of care for a patient who was admitted with syncopal episodes of unknown origin

instruct the patient to call for assistance before getting out of bed

Which nursing action can the RN delegate to the unlicensed assistive personnel working as telemetry technicians on the cardiac care unit?

observe heart rhythms for multiple patients who have telemetry monitoring

A patient who reports a "racing" heart and feeling "anxious" comes to the ER. The nurse places the patient on a heart monitor and obtains the following electrocardiograph (ECG) tracing. What action should the nurse take?

obtain the patients vital signs including O2

A patient's heart monitor shows a pattern of undulations of varying contours and amplitude with no measurable ECG pattern. The patient is unconscious, apneic and pulseless. Which action should the nurse take FIRST

perform immediate difibrillation

A patient who was admitted with a myocardial infarction has a 45 second episode of ventricular tachycardia, then converts to sinus rhythm with a heart rate of 98. What action should the nurse take next

prepare to give IV amiodaron per agency dysrhythmia protocol

Which information will the nurse include when teaching a patient with atrial flutter who is scheduled for a radiofrequency catheter ablation

the procedure uses electrical energy to destroy areas of the conduction system

a patient reports dizziness and shortnes of breath for several days. During heart monitoring in the ER, the nurse obtains the following electrocardiographic (ECG) tracing... how does the nurse interpret this rhythm

third degree atrioventricular AV block

The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm. Which method will be faster to use?

use the 3 second marker to count the number of QRS complexes in 6 seconds and multiply by 10

A patient's heart monitor shows that every other beat is earlier than expected, has no visible P wave and has a QRS complex that is wide and a bizarre shape. How will the nurse document this rhythm

ventricular bigeminy

the nurse obtains a rhythm strip on a patient who has had a myocardial infarction and makes the following analysis; no visible P waves, PR interval not measurable, ventricular rate of 162, R-R interval regular, QRS complex wide and distorted, and QRS duration of 0.18 seconds How should the nurse interpret this cardiac rhythm

ventricular tachycardia


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