IGGY 10 Chapter 31: Concepts of Care for Patients With Dysrhythmias

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification would the nurse suggest to avoid further slowing of the heart rate? "Make certain that your bath water is warm. "Avoid straining while having a bowel movement." "Limit your intake of caffeinated drinks to one a day." "Avoid strenuous exercise such as running."

"Avoid straining while having a bowel movement."

A nurse supervises an assistive personnel (AP) applying electrocardiographic monitoring. Which statement would the nurse provide to the AP related to this procedure? "Clean the skin and clip hairs if needed." "Add gel to the electrodes prior to applying them." "Place the electrodes on the posterior chest." "Turn off oxygen prior to monitoring the client."

"Clean the skin and clip hairs if needed."

The nurse asks a client who has experienced ventricular dysrhythmias about substance abuse. The client asks, "Why do you want to know if I use cocaine?" What is the nurse's best response? "Substance abuse puts clients at risk for many health issues." "The hospital requires that I ask you about cocaine use." "Clients who use cocaine are at risk for fatal dysrhythmias. "We can provide services for cessation of substance abuse."

"Clients who use cocaine are at risk for fatal dysrhythmias.

After teaching a client who has an implantable cardioverter-defibrillator (ICD), a nurse assesses the client's understanding. Which statement by the client indicates correct understanding of the teaching? "I would wear a snug-fitting shirt over the ICD." "I will avoid sources of strong electromagnetic fields." "I would participate in a strenuous exercise program." "Now I can discontinue my antidysrhythmic medication."

"I will avoid sources of strong electromagnetic fields."

A nurse teaches a client who experiences occasional premature atrial contractions (PACs) accompanied by palpitations that resolve spontaneously without treatment. Which statement would the nurse include in this client's teaching? "Minimize or abstain from caffeine." "Lie on your side until the attack subsides." "Use your oxygen when you experience PACs." «Take amiodarone daily to prevent PACs."

"Minimize or abstain from caffeine."

A nurse is assessing clients on a medical-surgical unit. Which client would the nurse identify as being at greatest risk for atrial fibrillation? A 45-year-old who takes an aspirin daily. A 50-year-old who is post coronary artery bypass graft surgery. A 78-year-old who had a carotid endarterectomy. An 80-year-old with chronic obstructive pulmonary disease.

A 50-year-old who is post coronary artery bypass graft surgery.

A nurse performs an admission assessment on a 75-year-old client with multiple chronic diseases. The client's blood pressure is 135/75 mm Hg and oxygen saturation is 94% on 2 L per nasal cannula. The nurse assesses the client's rhythm on the cardiac monitor and observes the reading shown below: What action would the nurse take first? Begin external temporary pacing. Assess peripheral pulse strength. Ask the client what medications he or she takes. Administer 1 mg of atropine

Ask the client what medications he or she takes.

A nurse cares for a client who is on a cardiac monitor. The monitor displayed the rhythm shown below: What action would the nurse take first? Assess airway, breathing, and circulation. Administer an amiodarone bolus followed by a drip. Cardiovert the client with a biphasic defibrillator. Begin cardiopulmonary resuscitation (CPR).

Assess airway, breathing, and circulation.

A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client's electrocardiogram. What action would the nurse take next? Administer intravenous diltiazem. Assess vital signs and level of consciousness. Administer sublingual nitroglycerin. Assess capillary refill and temperature.

Assess vital signs and level of consciousness.

A nurse prepares to defibrillate a client who is in ventricular fibrillation. Which intervention is appropriate for the nurse to perform prior to defibrillating this client? Make sure that the defibrillator is set to the synchronous mode. Administer 1 mg of intravenous epinephrine. Test the equipment by delivering a smaller shock at 100 J. Ensure that everyone is clear of contact with the client and the bed.

Ensure that everyone is clear of contact with the client and the bed.

The nurse is caring for a client on the medical-surgical unit who suddenly becomes unresponsive and has no pulse. The cardiac monitor shows the rhythm below: After calling for assistance and a defibrillator, what action would the nurse take next? Perform a pericardial thump. Initiate cardiopulmonary resuscitation (CPR). Start an 18-gauge intravenous line. Ask the Client's family about code status.

Initiate cardiopulmonary resuscitation (CPR).

A telemetry nurse assesses a client who has a heart rate of 35 beats/min on the cardiac monitor. Which assessment would the nurse complete next? Pulmonary auscultation Pulse strength and amplitude Level of consciousness Mobility and gait stability

Level of consciousness

A nurse prepares to discharge a client with a cardiac dysrhythmia who is prescribed home health care services. Which priority information would be communicated to the home health nurse upon discharge? Medication orders for home Immunization history Religious beliefs Nutrition preferences

Medication orders for home

A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse? Midsternal chest pain Increased urine output Mild orthostatic hypotension P wave touching the T wave

Midsternal chest pain

A nurse cares for a client with atrial fibrillation who reports fatigue when completing activities of daily living. What intervention would the nurse implement to address this client's concerns? Administer oxygen therapy at 2 L per nasal cannula. Provide the client with a sleeping pill to stimulate rest. Schedule periods of exercise and rest during the day. Ask assistive personnel (AP) to help bathe the client.

Schedule periods of exercise and rest during the day.

A nurse administers prescribed adenosine to a client. Which response would the nurse assess for as the expected therapeutic response? Decreased intraocular pressure Increased heart rate Short period of asystole Hypertensive crisis

Short period of asystole

A nurse assesses a client's electrocardiogram (ECG) and observes the reading shown below: How would the nurse document this client's ECG strip? Ventricular tachycardia Ventricular fibrillation Sinus rhythm with premature atrial contractions (PACs) Sinus rhythm with premature ventricular contractions (PVCs)

Sinus rhythm with premature ventricular contractions (PVCs)

After assessing a client who is receiving an amiodarone intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings: Based on the assessments, what action would the nurse take? Stop the infusion and flush the IV. Slow the amiodarone infusion rate. Administer IV normal saline. Ask the client to cough and deep breathe.

Slow the amiodarone infusion rate.

A nurse assesses a client with atrial fibrillation. Which manifestation would alert the nurse to the possibility of a serious complication from this condition? Sinus tachycardia Speech alterations Fatigue Dyspnea with activity

Speech alterations

A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. What action would the nurse take prior to the cardioversion? Administer intravenous adenosine. Turn off oxygen therapy. Ensure that a tongue blade is available. Position the client on the left side.

Turn off oxygen therapy.

5. A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication would the nurse expect to find on this client's medication administration record to prevent a common complication of this condition? a. Sotalol b. Warfarin C. Atropine d. Lidocaine

b. Warfarin

A nurse assesses a client's electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How would the nurse interpret this observation? a. The client has hyperkalemia causing irregular QRS complexes. b. Ventricular tachycardia is overriding the normal atrial rhythm. c. The client's chest leads are not making sufficient contact with the skin. d. Ventricular and atrial depolarizations are initiated from different sites.

d. Ventricular and atrial depolarizations are initiated from different sites.