MSIII Module 6
Which of the following may be seen when doing a physical assessment of a patient with a dysrhythmia? Select all that apply.
Neck vein distention Changes in level of consciousness
The client has most likely developed
pulmonary embolism
When cardiac output is increased, the amount of oxygen reaching the tissues and vital organs is diminished.
False
The clinical procedure the nurse will anticipate preparing the client for is
1. Chest tube 2. X- Ray
Which of the following are contraindications for sotalol (Betapace)? Select all that apply.
Asthma Sinus bradycardia Heart failure
Highlight the clinical findings in the nursing note and arterial blood gas results that support the client's health is improving.
Client is alert and oriented x4 Minimal amount of clear sputum noted with cough Normal sinus rhythm noted on ECG tracing, peripheral pulses +3, skin warm dry, heart rate 96 etc, All gasses
is used in emergency situations as the treatment of choice for ventricular fibrillation and pulseless VT, the most common cause of abrupt loss of cardiac function and sudden cardiac death.
Defibrillation
A MRI is usually taken after the procedure and prior to discharge to document the position of leads in addition to ensuring that the procedure did not cause a pneumothorax.
False
Because junctional tachycardia is caused by increased automaticity, cardioversion is an effective treatment.
False
Cardioversion and defibrillation are used to treat tachydysrhythmias by delivering an electrical current that depolarizes a critical mass of myocardial cells. When the cells repolarize, the AV node is usually able to recapture its role as the heart's pacemaker.
False
Defibrillators consist of two components: an electronic pulse generator and pacemaker electrodes, which are located on leads or wires.
False
Electrical cardioversion is indicated for patients with atrial fibrillation that is hemodynamically stable.
False
For long-term management, patients with an ejection fraction less than 55% should be considered for an implantable cardioverter defibrillator (ICD).
False
PVCs that are frequent and persistent may be treated with labetalol or verapamil, but long-term pharmacotherapy for only PVCs is not usually indicated.
False
The appropriate ECG complex should immediately follow the pacing spike; therefore, a T wave should follow an atrial pacing spike and a QRS complex should follow a ventricular pacing spike.
False
The initial treatment of choice for conduction abnormalities is an IV bolus of verapamil, although it is not effective in second-degree AV block, type II, or third-degree AV block.
False
When assessing the client with a three-chamber chest drainage device, anticipated findings include the following:
Gentle rise of water in the water seal chamber during inhalation 2 cm of water in the water seal chamber Intermittent bubbling in the water seal chamber during exhalation
Which of the following are contraindications of atropine? Select all that apply.
Glaucoma Bronchial asthma Bladder neck obstruction
The is an electronic device that detects and terminates life-threatening episodes of tachycardia or fibrillation, especially those that are ventricular in origin.
ICD
Based on the clinical full presentation, identify whether or not the nursing intervention is indicated.
Implement seizure precautions: Not Indicated Prepare suction: Indicated Perform a head tilt chin lift: Indicated Place the client in a high fowlers position: Not Indicated Prepare the client for intubation: Indicated Administer intravenous fluid bolus: Not Indicated Deliver manual breaths with ventilation bag: Indicated
Which of the following are characteristics of a junctional rhythm not caused by complete heart block? Select all that apply.
P wave: May be absent, after the QRS complex, or before the QRS; may be inverted, especially in lead II P:QRS ratio: 1:1 or 0:1 QRS shape and duration: Usually normal, but may be abnormal
Which of the following are characteristics of First-Degree AV block? Select all that apply.
QRS shape and duration: Usually normal, but may be abnormal Ventricular and atrial rhythm: Depends on the underlying rhythm Ventricular and atrial rate: Depends on the underlying rhythm
Based on the arterial blood gases, the client is experiencing
Respiratory acidosis
A chest x-ray is usually taken after the procedure and prior to discharge to document the position of leads in addition to ensuring that the procedure did not cause a pneumothorax.
True
Because junctional tachycardia is caused by increased automaticity, cardioversion is not an effective treatment
True
Cardioversion and defibrillation are used to treat tachydysrhythmias by delivering an electrical current that depolarizes a critical mass of myocardial cells. When the cells repolarize, the SA node is usually able to recapture its role as the heart's pacemaker.
True
Defibrillation is used in emergency situations as the treatment of choice for ventricular fibrillation and pulseless VT, the most common cause of abrupt loss of cardiac function and sudden cardiac death.
True
Epinephrine can increase the mean arterial pressure by increasing the cardiac index and stroke volume, as well as systemic vascular resistance and heart rate.
True
For long-term management, patients with an ejection fraction less than 35% should be considered for an implantable cardioverter defibrillator (ICD)
True
PVCs that are frequent and persistent may be treated with amiodarone or sotalol, but long-term pharmacotherapy for only PVCs is not usually indicated.
True
Pacemakers consist of two components: an electronic pulse generator and pacemaker electrodes, which are located on leads or wires.
True
Patients with coronary artery disease who are 40 days postacute MI with moderate to severe left ventricular dysfunction (ejection fraction less than or equal to 35%) are at risk of sudden cardiac death and therefore an ICD is indicated.
True
The appropriate ECG complex should immediately follow the pacing spike; therefore, a P wave should follow an atrial pacing spike and a QRS complex should follow a ventricular pacing spike.
True
Torsades de pointes is a polymorphic VT preceded by a prolonged QT interval, which could be congenital or acquired.
True
Untreated hypomagnesemia may make hypocalcemia refractory to drug therapy, so abnormalities in magnesium and calcium should be corrected simultaneously.
True
Ventricular asystole is treated the same as PEA, focusing on high-quality CPR with minimal interruptions and identifying underlying and contributing factors.
True
When cardiac output is reduced, the amount of oxygen reaching the tissues and vital organs is diminished.
True
Which of the following are adverse effects of atropine? Select all that apply.
Urinary retention Tachycardia Mydriasis
Which of the following are characteristics of second-degree AV block, type I? Select all that apply.
Ventricular and atrial rate: Depends on the underlying rhythm, but the ventricular rate is lower than the atrial rate. QRS shape and duration: Usually normal, but may be abnormal P wave: In front of the QRS complex; shape depends on underlying rhythm. PR interval: The PR interval becomes longer with each succeeding ECG complex until there is a P wave not followed by a QRS.
Which of the following are characteristics of third degree atrioventricular block?
Ventricular and atrial rhythm: The PP interval is regular and the RR interval is regular, but the PP interval is not equal to the RR interval. Ventricular and atrial rate: Depends on the escape rhythm (idionodal or idioventricular) and underlying atrial rhythm, but the ventricular rate is lower than the atrial rate. P wave: Depends on underlying rhythm.
Automated external defibrillators (AEDs), which are now found in many public areas, use hands delivery for the electrical current.
off
The permanent generator, which often weighs less than 1 oz and is the size of a large book of matches, is usually implanted in a pocket created in the pectoral region, below the clavicle, or behind the breast, especially in young women.
subcutaneous
