ECG PrepU

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A client with a forceful, pounding heartbeat is diagnosed with mitral valve prolapse. Which client statement indicates to the nurse a need for additional teaching?

"I can still drink coffee and tea."

The nurse assesses the client and notes no pulse. The nurse calls for assistance to others in the mall and requests which piece of equipment?

An automatic external defibrillator

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 caring for a patient with a dysrhythmia understands that the P wave on an electrocardiogram (ECG) represents what phase of the cardiac cycle?

Atrial depolarization

A patient's ECG tracing reveals a ventricular rate between 250 and 400, with saw-toothed P waves. The nurse correctly identifies this dysrhythmia as which of the following?

Atrial flutter

The nurse has made this interpretation based on the PR interval of

0.12 and 0.2 seconds.

Which medication is the drug of choice for sinus bradycardia?

Atropine

The patient is told that she has second-degree AV block with symptomatic bradycardia. The patient will be treated with an anticholinergic that blocks the effects of the vagal nerve.

Atropine sulfate

A patient tells the nurse "my heart is skipping beats again; I'm having palpitations." After completing a physical assessment, the nurse concludes the patient is experiencing occasional premature atrial complexes (PACs). The nurse should instruct the patient to complete which of the following?

Avoid caffeinated beverages.

postimplantation instructions must a nurse provide a patient with a permanent pacemaker?

Avoid sources of electrical interference

A client has been living with an internal, fixed-rate pacemaker. You're checking his readings on a cardiac monitor and notice an absence of spikes. What should you do?

Double-check the monitoring equipment.

A patient is being examined for medical management of atrial flutter. The nurse reviews the ECG strip. He expects to see which of the following?

"Sawtooth" pattern to the waveform

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 the rhythm strip

The student asks, "How can I tell the difference between sinus rhythm and sinus bradycardia when I look at the EKG strip" The best reply by the nurse is which of the following?

"The only difference is the rate, which will be below 60 bpm in sinus bradycardia."

Which PR interval presents a first-degree heart block?

>.20 sec

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?

A client with atrial dysrhythmias

Which of the following postimplantation instructions must you provide to the client now that he has a permanent pacemaker?

Avoid sources of electrical interference.

Which medication is indicated for the patient with atrial fibrillation who is at high risk for stroke?

Coumadin

The nurse is caring for a client who is displaying a third-degree AV block on the EKG monitor. The client is symptomatic due to the slow heart rate. The most appropriate nursing diagnosis for this client would be which of the following?

Decreased cardiac output

After evaluating a client for hypertension, a physician orders atenolol (Tenormin), 50 mg P.O. daily. Which therapeutic effect should atenolol have?

Decreased cardiac output and decreased systolic and diastolic blood pressure

You are caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the dysrhythmia?

Elective cardioversion

Your client has been diagnosed with an atrial dysrhythmia. What would be a procedure used to treat this client?

Elective electrical cardioversion

You are caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?

Fluttering

Which of the following is a potential cause of premature ventricular complexes (PVCs)?

Hypokalemia

A 63-year-old client is in the cardiac step-down unit where you practice nursing. In your discussions about his condition, the client is puzzled as to what causes the heart to be an effective pump. Which of the following statements would you include in your response?

Inherent rhythmicity of cardiac muscle tissue

nursing interventions is required to prepare a patient with cardiac dysrhythmia for an elective electrical cardioversion?

Instruct the patient to restrict food and oral intake

"positive inotropic" effect is

It increases the force of the myocardial contraction.

The nurse is analyzing 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 which of the following?

Normal sinus rhythm

To evaluate a client's atrial depolarization, the nurse observes which part of the electrocardiogram waveform?

P Wave

Which of the following items are considered a part of the cardiac complex on an EKG strip?

P wave P-R interval T wave

tenderness and throbbing around the incision. The nurse observes mild swelling, erythema, and warmth at the site and suspects which of the following:

Pacemaker site infection

The nurse is assessing vital signs in a patient with a permanent pacemaker. What should the nurse document about the pacemaker?

Pacer rate

Undersensing occurs as a pacemaker malfunctions as a result of which of the following events?

Pacing spike occurs at the preset level despite the patient's intrinsic rhythm

While the nurse is taking the patient's vital signs, the patient states, "Occasionally, my heart skips a beat. Is this normal?" The nurse explains that this feeling is caused by which of the following?

Premature Atrial Complex

ECG waveforms characterizes conduction of an electrical impulse through the left ventricle?

QRS complex

Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion?

Valium

A client with second-degree atrioventricular heart block is admitted to the coronary care unit. The nurse closely monitors the client's heart rate and rhythm.

ventricular depolarization.


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