Disorders of Cardiac Conduction and Rhythm

Suddenly a client in the surgical intensive care unit develops ventricular fibrillation following open heart surgery. What does the nurse immediately prepare for?

Nonsynchronized defibrillation

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 presents with uncharacteristic chest pain, and his ECG reveals T-wave elevation. This finding suggests an abnormality with which aspect of the cardiac cycle?

Ventricular repolarization

A client with new onset atrial fibrillation (AF) is being admitted to the hospital for possible cardioversion. The initial vital signs include a heart rate of 160 and blood pressure of 90/60. The admission nurse anticipates the presence of a pulse deficit. To verify this finding which action would the nurse take?

With another nurse, assess the apical and radial pulses simultaneously for one minute.

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 client arrives at the emergency room with dizziness and a near syncopal episode. Vital signs include a heart rate of 46 and blood pressure of 86/50. The cardiac monitors show regular rhythm as above. The client states his physician has been running blood work to rule out hypothyroidism. Based on the rhythm, what does the nurse report the client has?

A symptomatic bradyarrhythmia

Which client on the nurse's team will be given priority for cardiac monitoring based on medical history?

Adolescent client resuscitated following drowning in a swimming pool that required CPR at the scene

Paroxysmal supraventricular tachycardia arises from which form of reentry?

Arterioventricular (AV) nodal

Brugada syndrome, an autosomal dominant disorder, manifests in adulthood as ST-segment elevation, right bundle branch block, and susceptibility to ventricular tachycardia. In Brugada syndrome, the timing of cardiac events is significant. When do these cardiac events typically occur?

During sleep or rest

A client is having an electrocardiogram (ECG) performed for a routine physical examination. The client states he has been feeling well and has no reports of pain or discomfort. The nurse observes a regular atrial and ventricular rate of 64, a PR interval of 0.26, and a QRS of 0.06 sec. The nurse determines that this rhythm is called:

First-degree heart block

The nurse is interpreting an electrocardiogram of a 65-year-old woman. Which should the nurse recognize as representing ventricular depolarization?

QRS complex

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 client with supraventricular tachycardia has received a dose of verapamil to slow the heart rate. Which explanation describes the effect of this drug on the heart?

Slows the sinoatrial (SA) node pacemaker and inhibits conduction in the atrioventricular (AV)

What does it mean when a client is in second-degree atrioventricular block and there is a relationship between the P waves and the QRS complex resulting in recurring PR intervals?

The association of P waves and QRS complexes is not random.

A group of nursing students is discussing ventricular dysrhythmias and one student is unsure why a client with frequent premature ventricular complexes (PVCs) has an irregular radial pulse. One of the other students explains that premature ventricular complexes often do not produce a palpable pulse due to:

decreased ventricular filling time.

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.

A nurse is monitoring a client with sick sinus syndrome who is experiencing lightheadedness, dizziness, and syncope. Which treatment will the nurse anticipate for this client?

Insertion of a pacemaker

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.

Sick sinus syndrome is suspected in the case of a child who is postoperative following cardiac surgery. Which nursing action is most appropriate?

Monitor the child's ECG for bradycardia.

A client with a history of renal insufficiency arrives at the emergency room complaining of severe shortness of breath (SOB), fatigue, and dizziness. The triage nurse immediately draws blood and attaches a cardiac monitor. As the shift continues, the nurse notes the above change in the ECG tracing. What should the nurse do first?

Check the lab results.