MEDSURG

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

A client with dilated cardiomyopathy is having frequent episodes of ventricular fibrillation. What medical treatment does the nurse anticipate the client will have to terminate the episode of ventricular fibrillation? internal cardioverter defibrillator (ICD) insertion pacemaker insertion radiofrequency ablation electrophysiological study

internal cardioverter defibrillator (ICD) insertion The implantable cardioverter defibrillator (ICD) is an electronic device that detects and terminates life-threatening episodes of tachycardia or fibrillation, especially those that are ventricular in origin. Patients at high risk of ventricular tachycardia (VT) or ventricular fibrillation who would benefit from an ICD are those who have survived sudden cardiac death syndrome, which usually is caused by ventricular fibrillation, or who have experienced spontaneous, symptomatic VT (syncope secondary to VT) not due to a reversible cause (called a secondary prevention intervention).

During electrical cardioversion, the defibrillator is set to synchronize with the electrocardiogram (ECG) so that the electrical impulse discharges during

ventricular depolarization In cardioversion, the defibrillator is set to synchronize with the electrocardiogram (ECG) on the cardiac monitor so that the electrical impulse discharges during ventricular depolarization.

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? A) Administer an IV bolus of atropine. B)Send the client to the cardiac catheterization laboratory. C) Prepare to client for cardioversion. D) Review the client's medication record.

A) Administer an IV bolus of atropine. Atropine 0.5 mg given rapidly as an intravenous bolus every 3 to 5 minutes to a maximum total dose of 3.0 mg is the medication of choice in treating symptomatic second-degree heart block. The client may need to be sent to the cardiac catheterization lab for a temporary pacemaker, but atropine should be tried first. Cardioversion is used to treat a fast heart rate. Reviewing the medication record will not help the client initially.

A client's electrocardiogram (ECG) tracing reveals a atrial rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as: Atrial flutter Atrial fibrillation Ventricular fibrillation Ventricular tachycardia

A- Flutter

The nurse is teaching a beginning EKG class to staff nurses. As the nurse begins to discuss the parts of the EKG complex, one of the students asks what the normal order of conduction through the heart is. What order does the nurse describe? A) Sinoatrial (SA) node, atrioventricular (AV) node, bundle of His, right and left bundle branches, and the Purkinje fibers B) AV node, SA node, bundle of His, right and left bundle branches, and the Purkinje fibers C) SA node, AV node, right and left bundle branches, bundle of His, and the Purkinje fibers D) SA node, AV node, bundle of His, the Purkinje fibers, and the right and left bundle branches

B) AV node, SA node, bundle of His, right and left bundle branches, and the Purkinje fibers

What is the drug of choice for a stable client with ventricular tachycardia? A) Atropine B) Amiodarone C) Procainamide D) Lidocaine

B) Amiodarone Amiodarone administered IV is the antidysrhythmic medication of choice for a stable patient with ventricular tachycardia. Atropine is used for bradycardia. Procainamide is used to treat and prevent atrial and ventricular dysrhythmias. Lidocaine is used for treating ventricular dysrhythmias.

When the nurse observes that the client's heart rate increases during inspiration and decreases during expiration, the nurse reports that the client is demonstrating A) normal sinus rhythm. B) sinus bradycardia. C) sinus dysrhythmia. D) sinus tachycardia.

C) sinus dysrhythmia. Sinus dysrhythmia occurs when the sinus node creates an impulse at an irregular rhythm.

A patient who had a myocardial infarction is experiencing severe chest pain and alerts the nurse. The nurse begins the assessment but suddenly the patient becomes unresponsive, no pulse, with the monitor showing a rapid, disorganized ventricular rhythm. What does the nurse interpret this rhythm to be? A)Ventricular tachycardia B)Atrial fibrillation C)Third-degree heart block D) Ventricular fibrillation

D) Ventricular fibrillation The most common dysrhythmia in patients with cardiac arrest is ventricular fibrillation, which is a rapid, disorganized ventricular rhythm that causes ineffective quivering of the ventricles. No atrial activity is seen on the ECG. The most common cause of ventricular fibrillation is coronary artery disease and resulting acute myocardial infarction. Ventricular fibrillation is always characterized by the absence of an audible heartbeat, a palpable pulse, and respirations.

The nurse is preparing a client for upcoming electrophysiology (EP) studies and possible ablation for treatment of atrial tachycardia. What information will the nurse include in the teaching?

During the procedure, the dysrhythmia will be reproduced under controlled conditions. During EP studies, the patient is awake and may experience symptoms related to the dysrhythmia. The client does not receive general anesthesia. The EP procedure time is not easy to determine. EP studies do not always include ablation of the dysrhythmia.

The nurse analyzes 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 PR interval that is 0.18 seconds long QRS complex that is 0.10 seconds long ST segment that is isoelectric in appearance

QT interval that is 0. 46 seconds long

Which is not a likely origination point for cardiac dysrhythmias?

bundle of His Cardiac dysrhythmias may originate in the atria, atrioventricular node, or ventricles

The nurse is placing electrodes for a 12-lead electrocardiogram (ECG). The nurse would be correct in placing an electrode on which area for V1?

right side of the sternum, fourth intercostal space view V1, the electrodes would be placed on the right side of the sternum, fourth intercostal space. V2 is the left side of the sternum, fourth intercostal space. V3 is midway between V2 and V4. V4 is at the mid-clavicular line, fifth intercostal space.