Test 3 chapter 26 med surge
The nurse is providing care to a patient who has just undergone an electrophysiologic (EP) study. The patient states that she is nervous about "things going wrong" during the procedure. What is the nurse's best response?
"The whole team will be monitoring you very closely for the entire procedure.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would be the nurse's best response?
"To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia.The ICD is a device that detects and terminates life-threatening episodes of ventricular tachycardia and ventricular fibrillation
The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF.
According to national standards, the nurse should anticipate the administration of what medication? Epinephrine 1 mg IV push
During a patient's care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery?
Atrial and ventricular tachycardias not responsive to other treatments
The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient?
Avoid exposure to high-voltage electrical generators
A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?
Bleeding at the implantation site
The nurse is caring for a patient who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment?
Cardiac monitoring
The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output?
Changes in level of consciousness Blood pressure tends to decrease with lowered cardiac output
A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention?
Defibrillation
New nurses on the telemetry unit have been paired with preceptors. One new nurse asks her preceptor to explain depolarization. What would be the best answer by the preceptor?
Depolarization is the electrical stimulation of the heart muscles."
A patient is scheduled for catheter ablation therapy. When describing this procedure to the patient's family, the nurse should address what aspect of the treatment?
Destruction of specific cardiac cells
A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patient's care?
Diagnose the dysrhythmia.
The nurse is caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?
ECG to compare time of onset of VT and onset of device's shock
The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?
Ensure no one is touching the patient at the time shock is delivered.
An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?
Fewer QRS complexes than P waves
An ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?
Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth.
When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?
Heart rate and rhythm
nurse is caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. nurse reviews the result of the patient's most recent cardiac imaging, which notes the presence of scarring on the atria.
How should the nurse best respond to this finding? Recognize this as a therapeutic goal of the procedure.
Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the cardiac intensive care unit. nurse's assessment reveals that the patient is experiencing neuromuscular paralysis.
How should the nurse best respond? Document this as an expected assessment finding.
A patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally.
IV heparin and Cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what? Control ventricular heart rate
A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a patient's cardiac function in what way?
Increasing the heart rate
The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?
Maintain adequate cardiac output.
The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the nurse do?
Maintain firm contact between paddles and patient skin.
A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurse's responsibility in the care of the patient's pacemaker?
Monitoring for pacemaker malfunction or battery failure
The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?
QRS complex The QRS complex represents the depolarization of the ventricles and, as such, the electrical activity of that ventricle.
The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?
Recognize that the view of the electrical current changes in relation to the lead placement
The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patient's care, the nurse should recognize what goal of this intervention?
Resynchronization
A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this patient's care, what nursing diagnosis is most appropriate?
Risk for activity intolerance Sinus bradycardia causes decreased cardiac output that is likely to cause activity intolerance.
The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient's heart? T wave
The T wave specifically represents ventricular muscle depolarization, also referred to as the resting state
During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor's best response?
The difference is the timing of the delivery of the electric current."
A group of nurses are participating in orientation to a telemetry unit. What should the staff educator tell this class about ST segments?
They are the part of an ECG that represents early ventricular repolarization.
The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?
Trancutaneous pacemaker emergency pacing may be started with transcutaneous pacing, which most defibrillators are now equipped to perform.
The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?
Use a conducting medium between the paddles and the skin.
A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse should describe what aspect of this treatment?
Using a cooled probe to eliminate the source of dysrhythmia
A patient the nurse is caring for has a permanent pacemaker implanted with the identification code beginning with VVI. What does this indicate?
Ventricular paced, ventricular sensed, inhibited
The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurse's assessment?
Vigilant monitoring of the patient's ECG
patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. nurse caring for this patient is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine.
What guidelines will the nurse follow when administering atropine? Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg.
The nurse is assessing a patient who had a pacemaker implanted 4 weeks ago. During the patient's most recent follow-up appointment, the nurse identifies data that suggest the patient may be socially isolated and depressed.
What nursing diagnosis is suggested by these data?Ineffective coping related to pacemaker implantation
The nurse is caring for a patient on telemetry. The patient's ECG shows a shortened PR interval, slurring of the initial QRS deflection, and prolonged QRS duration. What does this ECG show?
Wolf-Parkinson-White (WPW) syndrome
A patient calls his cardiologist's office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because
the nurse knows that the most frequent complication of ICD therapy is what? Oversensing of dysrhythmias
