Ch. 7 Dysrhythmia Interpretation and Management Critical Care
The patient is scheduled to have a permanent pacemaker implanted. The patient asks the nurse, "How long will the battery in this thing last?" The nurse should answer,
"Battery life varies depending on usage, but it can last up to 10 years."
The nurse using cardiac monitoring understands that each horizontal box on the electrocardiogram (ECG) paper indicates
40 milliseconds or 0.04 seconds duration
The normal rate for the SA node when the patient is at rest is
60 to 100 beats per minute
The nurse is calculating the rate for a regular rhythm. There are 20 small boxes between each P wave and 20 small boxes between each R wave. What is the ventricular rate?
75 beats/min
The patient is in chronic junctional escape rhythm with no atrial activity noted. Studies have demonstrated normal AV node function. This patient may be a candidate for which type of pacing?
Atrial pacing
Interpret the following rhythm:
Normal sinus rhythm
Which of the following is true about a patient diagnosed with sinus arrhythmia?
The heart rate varies, dependent on vagal tone and respiratory pattern
The patient is asymptomatic but is diagnosed with second-degree heart block Mobitz I. The patient is on digitalis medication at home. The nurse should expect that
a digitalis level would be ordered upon admission
The patient's heart rate is 70 beats per minute, but the P waves come after the QRS complex. The nurse correctly determines that the patient's heart rhythm is
an accelerated junctional rhythm
The nurse notices sinus bradycardia on the patient's cardiac monitor. The nurse should
assess for hemodynamic instability
The nurse is talking with the patient when the monitor alarms and shows a wavy baseline without a PQRST complex. The nurse should
assess the patient and the electrical leads
The patient is admitted with sinus pauses causing periods of loss of consciousness. The patient is asymptomatic, awake and alert, but fatigued. He answers questions appropriately. When admitting this patient, the nurse should first
assess the patient's medication profile
The nurse is reading the cardiac monitor and notes that the patient's heart rhythm is extremely irregular and that there are no discernible P waves. The ventricular rate is 90 beats per minute, and the patient is hemodynamically stable. The nurse realizes that the patient's rhythm is
atrial fibrillation
The nurse notices ventricular tachycardia on the heart monitor. When the patient is assessed, the patient is found to be unresponsive with no pulse. The nurse should
begin cardiopulmonary resuscitation and advanced life support
The patient is admitted with a condition that requires cardiac rhythm monitoring. To apply the monitoring electrodes, the nurse must first
clip chest hair if needed
The patient's heart rate is 165 beats per minute. The cardiac monitor shows a rapid rate with narrow QRS complexes. The P waves cannot be seen, but the rhythm is regular. The patient's blood pressure has dropped from 124/62 mm Hg to 78/30 mm Hg. The patient's skin is cold and diaphoretic, and the patient is complaining of nausea. The nurse prepares the patient for
emergent cardioversion
The rhythm on the cardiac monitor is showing numerous pacemaker spikes, but no P waves or QRS complexes following the spikes. The nurse recognizes this as:
failure to capture
The patient has a permanent pacemaker in place with a demand rate set at 60 beats/min. The cardiac monitor is showing a heart rate of 44 beats/min with no pacemaker spikes. The nurse recognizes this as:
failure to pace
The nurse is examining the patient's cardiac rhythm strip in lead II and notices that all of the P waves are upright and look the same except one that has a different shape and is inverted. The nurse realizes that the P wave with the abnormal shape is probably
from some area in the atria other than the SA node
The patient has an irregular heart rhythm. To determine an accurate heart rate, the nurse would first
identify the markers on the ECG paper that indicate a 6-second strip
The patient's heart rhythm shows an inverted P wave with a PR interval of 0.06 seconds. The heart rate is 54 beats per minute. The nurse recognizes the rhythm is due to the
loss of sinus node activity
The nurse notices that the patient has a first-degree AV block. Everything else about the rhythm is normal. The nurse should
monitor the rhythm and patient's condition
The nurse understands that in a third-degree AV block
none of the P waves are conducted to the ventricles
One of the functions of the atrioventricular (AV) node is to
slow the impulse arriving from the SA node
The nurse caring for patients on cardiac monitors assesses the patient with a prolonged QT interval for
the development of lethal dysrhythmias
The patient has a permanent pacemaker inserted. The provider has set the pacemaker to the demand mode at a rate of 60 beats per minute. The nurse realizes that
the pacemaker will pace only if the patient's intrinsic heart rate is less than 60 beats per minute
The patient is having premature ventricular contractions (PVCs). The nurse's greatest concern should be:
the proximity of the R wave of the PVC to the T wave of a normal beat
The patient is admitted with a fever and rapid heart rate. The patient's temperature is 103 F (39.4 C). The nurse places the patient on a cardiac monitor and finds the patient's atrial and ventricular rates are above 105 beats per minute. P waves are clearly seen and appear normal in configuration. QRS complexes are normal in appearance and 0.08 seconds wide. The rhythm is regular, and blood pressure is normal. The nurse should focus on providing:
treatment to lower temperature
The nurse caring for patients with cardiac monitoring understands that when an electrical signal is aimed directly at the positive electrode, the inflection will be:
upright
The nurse is caring for a patient who is on a cardiac monitor. The nurse realizes that the sinus node is the pacemaker of the heart because it is
the fastest pacemaker cell in the heart
