PrepU Ch 26 Management of Pts with Dysrhythmias & Conduction Problems
The nursing student asks the nurse how to tell the difference between ventricular tachycardia and ventricular fibrillation on an electrocardiogram strip. What is the best response?
"Ventricular fibrillation is irregular with undulating waves and no QRS complex. Ventricular tachycardia is usually regular and fast, with wide QRS complexes."
PR interval for normal sinus rhythm
0.12 and 0.2 sec
A nurse provides morning care for a client in the intensive care unit (ICU). Suddenly, the bedside monitor shows ventricular fibrillation and the client becomes unresponsive. After calling for assistance, what action should the nurse take next?
Begin cardiopulmonary resuscitation
The nurse analyzes the electrocardiogram (ECG) strip of a stable patient admitted to the telemetry unit. The client's ECG strip demonstrates PR intervals that measure 0.24 seconds. What is the nurse's most appropriate action?
Document the findings and continue to monitor the patient
The client has just been diagnosed with a dysrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
SA node initiates impulse
The nurse is working with a client with a new onset of atrial fibrillation during a three-month follow-up visit. The healthcare provider is planning a cardioversion, and the client asks the nurse why there is a wait for the treatment. What is the best response by the nurse?
Your atrial chambers may contain blood clots now, so you must take an anticoagulant for a few weeks before the cardioversion."
Which of the following medication classifications is more likely to be expected when the nurse is caring for a client with atrial fibrillation?
anticoagulant
The nurse is assessing a patient with a probable diagnosis of first-degree AV block. The nurse is aware that this dysrhythmia is evident on an ECG strip by what indication?
delayed conduction, producing a prolonged PR interval
The nurse is assessing a client with mitral regurgitation. The nurse expects to note what finding in this client?
dyspnea, fatigue, weakness
premature ventricular contractions sign of
fluttering/heart skipping
potential cause of premature ventricular complexes (PVCs)
hypokalemia
A client asks the nurse what causes the heart to be an effective pump. The nurse informs the client that this is due to the:
inherent rhythmicity of cardiac muscle tissue.
on 12 lead where is V1 placed
right side of sternum, 4th intercostal space
A client is diagnosed with a dysrhythmia at a rate slower than 60 beats/minute with a regular interval between 0.12 and 0.20 seconds. What type of dysrhythmia does the client have?
sinus bradycardia
dysrhythmia common in older adults
sinus bradycardia
A client is unconscious on arrival to the emergency department. The nurse in the emergency department identifies that the client has a permanent pacemaker due to which characteristic?
spike on rhythm strip
The nurse knows which heart rhythm occurs when the atrial and ventricular rhythms are both regular, but independent of each other?
3rd degree heart block
To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?
P wave
The nurse is monitoring a patient in the postanesthesia care unit (PACU) following a coronary artery bypass graft, observing a regular ventricular rate of 82 beats/min and "sawtooth" P waves with an atrial rate of approximately 300 beat/min. How does the nurse interpret this rhythm?
atrial flutter
The licensed practical nurse is co-assigned with a registered nurse in the care of a client admitted to the cardiac unit with chest pain. The licensed practical nurse is assessing the accuracy of the cardiac monitor, which notes a heart rate of 34 beats/minute. The client appears anxious and states not feeling well. The licensed practical nurse confirms the monitor reading. When consulting with the registered nurse, which of the following is anticipated?
The registered nurse administering atropine sulfate intravenously
The nurse is assigned the following client assignment on the clinical unit. For which client does the nurse anticipate cardioversion as a possible medical treatment?
atrial dysrhythmias
The nurse analyzes a 6-second electrocardiogram (ECG) tracing. The P waves and QRS complexes are regular. The PR interval is 0.18 seconds long, and the QRS complexes are 0.08 seconds long. The heart rate is calculated at 70 bpm. The nurse correctly identifies this rhythm as
normal sinus rhythm
A patient comes to the emergency department with reports of chest pain after using cocaine. The nurse assesses the patient and obtains vital signs with results as follows: blood pressure 140/92, heart rate 128, respiratory rate 26, and an oxygen saturation of 98%. What rhythm on the monitor does the nurse anticipate viewing?
sinus tachycardia
The nurse working in the emergency department places a client in anaphylactic shock on a cardiac monitor and sees the cardiac rhythm shown. Which dysrythmia should the nurse document?
ventricular tachycardia
the nurse would anticipate a pt with a fib being prescribed
warfarin
