disorders of cardiac conduction of rhythm

A client's electrocardiogram monitor begins to sound an alarm and shows sustained ventricular fibrillation. The client is unconscious and without a pulse. Which priority intervention should the nurse take?

Defibrillate the client

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 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.

Which antiarrhythmic medication works by blunting the effect of sympathetic nervous system stimulation on the heart?

Beta-blockers, such as metoprolol

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 who will be undergoing a Holter monitor examination would be given which instruction?

"Keep a diary of your activities and symptoms throughout the examination."

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

Nursing students who are studying for their upcoming cardiac exam are discussing how the heart could possibly continue to beat once removed from the body. One of the students explains that this phenomenon is directly related to automaticity. What is automaticity?

Inherent spontaneous action-potential

Respiratory sinus dysrhythmia is considered a more optimal rhythm than a rhythm where all RR intervals are equal. In respiratory sinus dysrhythmia, what is the variation in cardiac cycles related to?

Intrathoracic pressure changes that occur with respiration

A 28-year-old client is admitted to the hospital for severe dehydration following a marathon, with fatigue the only complaint. Admission vital signs include a heart rate of 38, blood pressure 98/60, RR 16. Cardiac monitor reveals regular QRS complexes preceded by normal P waves. Which of the following does the nurse determine is the most likely cause for the bradycardia?

Large stroke volume

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.

ECG monitoring has been found to be more sensitive than a client's report of symptoms when identifying transient ongoing myocardial ischemia. Why is this?

Most ECG-detected ischemic events are clinically silent.

A monitored hospitalized client with a pulmonary embolism has been in atrial fibrillation (AF) for 4 days. The nurse observes the rhythm spontaneously convert to a normal sinus rhythm. Which form of AF is this?

Paroxysmal

A client experiencing a sinus arrest would demonstrate which symptom or finding?

Prolonged periods of asystole demonstrated on an electrocardiogram

What is the correct sequence for the generation of electrical impulses in the heart causing ventricular contraction?

SA node - AV node - bundle of His - bundle branches - Purkinje fibers

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 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 20-year-old college student, with no past medical history, arrives at the emergency room complaining of severe palpitations and dizziness that started this morning following a night of studying. The student is very upset that this is happening because the final exams are the following day. The cardiac monitor shows a heart rate of 110, regular rhythm with occasional premature ventricular complexes. The nurse explains to the student that this can happen in healthy hearts and is usually caused by stimulation of:

Sympathetic nervous system

Which type of pacing involves the placement of large patch electrodes on the anterior and posterior chest wall that can be connected by a cable to an external pulse generator?

Transcutaneous

A client presents with sinus bradycardia. What is the nurse's best action?

assess the clients history

Which cardiac drug classification decreases sympathetic outflow to the heart and is the is the cornerstone of therapy for catecholaminergic polymorphic ventricular tachycardia (CPVT)?

beta-adrengic blockers

Which dysrhythmia is considered to be the most fatal and requires immediate treatment?

ventricular fibrilation

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.

Which client will the nurse prioritize to assess first?

the client with sinus arrest

The nurse is caring for a client who develops atrial fibrillation. What concern is the highest priority for this client?

the risk of emboli

The nurse is assisting with a synchronized cardioversion for a client with atrial fibrillation (AF). Which waveform does the nurse understand the discharge of electrical energy should be synchronized with?

R wave

Following angioplasty for a blocked coronary artery following a myocardial infarction, a client is prescribed serial 12-lead ECGs for three days. On the second day, the nurse notices a distinct difference in the QRS morphology from the previous ECG. Which is the best action for the nurse to take?

Repeat ECG with proper lead placement.

The nurse is caring for a client who suffered a massive myocardial infarction and is scheduled for an immediate permanent pacemaker insertion due to severe ischemia and damage to both SA and AV nodes. The nurse would expect which of the following?

Bradycardia with rate of 20-40

A client is visiting the primary physician and appears extremely nervous. The intake nurse does his vital signs and notes an increase in both his heart rate and blood pressure. In an effort to better understand the client's presenting signs and symptoms the nurse asks the client about his concerns and the client states that the person who performed his pre-visit told him that he had a dysrhythmia. Which is the most therapeutic response about cardiac dysrhythmias that the nurse can make?

They can occur in diseased or healthy hearts.

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 re polarization

A client with a history of angina presents with uncharacteristic chest pain. The subsequent electrocardiogram (ECG) reveals T-wave elevation. This finding suggests an abnormality with which aspects of the cardiac cycle?

ventricular repolarization