MED/SURG2: Chapter 35 Ass. of cardiac rhythm

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The nurse is reviewing discharge instructions with a patient that received an implantable cardioverter-defibrillator (ICD). Which patient statement indicates the need for further teaching?

"I should avoid flying for three years."

A patient with a newly inserted pacemaker receives discharge instructions from the nurse. Which patient statement indicates that further teaching is required?

"I should avoid using microwave ovens."

A patient reports a fluttering feeling in the chest. The nurse assesses a rhythm of supraventricular tachycardia (PSVT), a heart rate of 150 beats per minute, and a blood pressure of 120/60 mm Hg. The nurse anticipates that the patient's plan of care will include what treatments? Select all that apply.

-Intravenous adenosine -Intravenous β-blockers -Intravenous calcium channel blockers -Vagal stimulation

A patient who underwent a cardioverter-defibrillator implant (ICD) procedure is being discharged from the health care facility. Which instructions should the nurse give the patient and caregiver? Select all that apply.

-Keep the incision dry for four days after insertion or as instructed -Avoid large magnets and strong electromagnetic fields -Inform the cardiologist if the implanted ICD fires

The nurse is monitoring a patient in the intensive care unit. Which are the most common leads selected for continuous monitoring? Select all that apply.

-Lead II -Lead V 1

Assessment findings of a patient on a cardiac unit include decreased heart rate (HR), decreased cardiac output (CO), and type I second-degree atrioventricular (AV) block. The nurse identifies that what ECG findings are characteristic of this rhythm and may be responsible for the patient's symptoms? Select all that apply.

-Slower ventricular rateSlower ventricular rate -Progressive lengthening of PR intervals -Blocked QRS complexes

The nurse monitors the electrocardiogram (ECG) of a patient diagnosed with acute coronary syndrome. The patient's baseline rhythm is sinus rhythm. Which additional ECG findings are most suggestive of myocardial infarction? Select all that apply.

-T-wave inversion -Pathologic Q wave -Elevated ST segment

The nurse calculates what ventricular rate on the following electrocardiogram (ECG) tracing? Record the answer using a whole number rounded to the nearest 10. __ beats per minute

80

A patient has sought care following a syncopal episode of unknown etiology. The nurse anticipates that what will be included in the patient's treatment plan?

A head-up tilt-test

What is a disadvantage of a centralized monitoring system?

It requires continuous observation of patients' ECGs

Which statement made by the student nurse indicates the need for additional teaching about electrocardiograms?

Six bipolar leads (V1 through V6) measure the electrical forces in the horizontal plane.

After synchronized cardioversion, a patient's electrocardiogram (ECG) tracing reveals the following. How should the nurse interpret the findings?

The cardioversion was successful.

The nurse provides teaching to a group of nursing students about radiofrequency catheter ablation therapy and should include what information?

The therapy uses electrical energy to remove problematic areas of the heart's conduction system.

The registered nurse is reviewing a wireless electrocardiogram (ECG) monitoring system with a nursing student. Which statement made by the student indicates the need for further teaching? 1 "It fails to record the postevent portion of the ECG." 2 "It can automatically save the preevent portion of the ECG." 3 "It continuously monitors and interprets the findings of patients." 4 "It sends an alert when a patient's measurements fall outside the set parameters."

"It fails to record the postevent portion of the ECG." The wireless ECG monitoring systems continue to record the postevent portion of ECG and send it to the healthcare provider. The wireless ECG monitoring systems can automatically save the preevent portion of the ECG, continuously monitor and interpret the findings of a patient, and send an alert when patient rhythm or measurements fall outside the set parameters.

The nurse provides discharge teaching to a patient that underwent pacemaker implantation in the left chest. What should the nurse include in the instructions? Select all that apply.

-Avoid direct blows to the incision site -Monitor pulse and inform the health care provider if the heart rate drops below the predetermined rate -Microwave ovens are safe to use

What should the nurse include in discharge instruction for a patient with an implantable cardioverter-defibrillator (ICD)? Select all that apply.

-Avoid large magnets and strong electromagnetic fields -Obtain and wear a Medic Alert ID device at all times -Avoid lifting arm on ICD side above the shoulder until approved

A nurse provides care to a patient with atrial flutter that is clinically stable. The nurse anticipates a prescription for which types of medication? Select all that apply.

-Calcium channel blocker -Antidysrhythmia medication -β- blocker

The nurse teaches a group of nursing students about telemetry monitoring. The nurse should provide information that the steps for applying electrodes should be performed in what order?

-Clip excessive hair with scissors -Gently rub the skin with dry gauze -Affix the electrodes -Monitor for artifact

Esmolol is prescribed for some patients with cardiac problems because of what actions it has on the heart's conduction system? Select all that apply.

-Decreases automaticity of the SA node -Slows the impulse conduction in the AV node

The nurse is caring for a patient that develops atrial fibrillation. Which treatments may be included the patient's treatment plan? Select all that apply

-Electrical cardioversion -Anticoagulation therapy -Prepare for radiofrequency catheter ablation

What should a nurse advise a group of caregivers with regards to a patient with an implantable cardioverter-defibrillator (ICD)? Select all that apply.

-If the ICD fires more than once, contact the emergency response system (ERS) -Report any signs of infection at incision site -Restrict magnetic resonance imaging (MRI) scan -Restrict the lifting of the arm on the ICD side above the shoulder until approved.

The nurse reviews a patient's admission history and identifies what findings that may be the cause of the patient's sinus bradycardia? Select all that apply.

-Increased intracranial pressure -Hypothermia -Calcium channel blockers

The nurse provides teaching about the conduction system of the heart to a group of nursing students. The nurse should include that the electrical impulses travel through the heart in what order?

-Sinoatrial node -Internodal pathways -Atrioventricular node -Bundle of His -Purkinje fibers

The nurse documents that a patient is in normal sinus rhythm. The nurse made this interpretation based on what electrocardiogram (ECG) characteristics? Select all that apply.

-The R-R intervals are relatively consistent -One P wave precedes each QRS complex -The T wave is upright.

The nurse presents information about electrocardiogram (ECG) changes associated with myocardial infarction (MI) to a group of nursing students. What should the nurse include in the information? Select all that apply. 1 The ST segment will be elevated. 2 The T wave will be normal. 3 A pathologic Q wave that develops during MI is wide and deep. 4 The pathologic Q wave will eventually disappear from the ECG. 5 A physiologic Q wave is normally very short and narrow.

-The ST segment will be elevated -A pathologic Q wave that develops during MI is wide and deep -A physiologic Q wave is normally very short and narrow. The typical ECG changes associated with MI are pathologic Q wave, ST segment elevation, and T wave inversion. ST segment elevation is considered significant if it is 1 mm or more above the isoelectric line in at least two contiguous leads. A pathologic Q wave that develops during MI is wide (greater than 0.03 seconds in duration) and deep (greater than or equal to 25% of the height of the R wave). The pathologic Q wave may remain on the ECG indefinitely. A physiologic Q wave is the first negative deflection following the P wave. It is normally very short and narrow

A patient undergoing treatment for dysrhythmia is provided with a Holter monitor. What information should the nurse include in the patient teaching about the test? Select all that apply.

-The monitor records the electrocardiogram (ECG) when the patient is ambulatory. -The patient should record activities and any symptoms in a diary -New technology using smart phone apps can obtain and save electrocardiogram (ECG) recordings -The monitor records the electrocardiogram (ECG) when the patient performs daily activities.

The nurse is preparing to perform an electrocardiogram (ECG) on a patient. The nurse observes artifact on the monitor. What are possible causes of the artifact? Select all that apply. 1 The patient has dry skin. 2 The patient is shivering. 3 The conductive gel is moist. 4 Electrical interference is present. 5 The leads and electrodes are not secure.

-The patient is shivering -Electrical interference is present -The leads and electrodes are not secure Muscle activity caused by shivering of the patient, electrical interference, or loose leads and electrodes can cause distorted baseline and waveforms called artifact on the electrocardiogram (ECG). Oily skin is wiped dry with alcohol to prepare the patient for ECG. Electrodes may have to be replaced if conductive gel has dried out.

A patient is diagnosed with pulseless ventricular tachycardia. The nurse should perform the steps of defibrillation in what order?

-Turn the defibrillator on and select the proper energy level -Check to see that the synchronizer switch is turned off. -Apply conductive materials to the chest -Charge the defibrillator using the button on the defibrillator or the paddles -Position the paddles firmly on the chest wall over the conductive material -Call and look to see that everyone is "all clear" -Deliver the charge by depressing buttons on both paddles simultaneously

The nurse provides education to a group of nursing students about cardiac conditions that are common causes of dysrhythmias. What should the nurse include in the teaching? Select all that apply.

-Valve disease -Conduction defects -Accessory pathways

The nurse reviews the cardiac cycle and ectopic impulses. The nurse identifies that the greatest risk to the patient is when the ectopy occurs in which part of the cycle?

5

The nurse analyzes a patient's electrocardiogram (ECG) and determines that there are 8 R-R intervals in a span of six seconds. What should the nurse document as the patient's heart rate? Record the answer using a whole number. __ beats/minute.

80 The heart rate can be calculated from an ECG by counting the number of R-R intervals in six seconds and multiplying that number by 10. In this case, the patient's ECG has eight R-R intervals. Therefore, 8 multiplied by 10 is 80.

A patient develops symptomatic sinus tachycardia. The nurse recognizes that which drug will likely be included in the patient's treatment plan?

Adenosine

A patient with chest pain experiences a heart rate of 200 beats/minute and blood pressure of 80/50 mm Hg. The electrocardiogram shows absent P waves. The nurse expects that which intravenous medication will be prescribed?

Adenosine

The nurse is caring for a patient with monomorphic ventricular tachycardia that is clinically stable. What is appropriate to be included on the patient's treatment plan?

Administer amiodarone

A patient on a cardiac unit is shivering. What does the nurse expect to see on the patient's ECG tracing?

Artifact

The nurse responds to a cardiac monitor alarm and notes that atrial flutter has developed on a patient's electrocardiogram (ECG). The nurse visualizes the patient's room and notes that the patient is awake and talking. Which action should the nurse take?

Assess the patient for dyspnea

The nurse is caring for a patient 24 hours after the patient underwent pacemaker insertion surgery. What will be included on the postoperative plan of care?

Assessing the incision for any redness, swelling, or discharge

A patient states, "I feel tired all the time, and I struggle with activities of daily living." When auscultating the patient's heart rate, the nurse notes disorganization of atrial electrical activity and records a rate of 120 bpm. Which rhythm does the nurse anticipate observing?

Atrial fibrillation

The nurse finds that a patient has an atrial rate of 450 beats per minute and a ventricular rate of 150 beats per minute. What condition is the patient likely experiencing?

Atrial fibrillation

The nurse observing a telemetry monitor notes that a patient that was in sinus rhythm is now in a different rhythm. The electrocardiogram (ECG) now shows no P waves, fine and wavy lines between the QRS complexes, QRS complexes that measure 0.08 sec, and QRS complexes that occur irregularly with a rate of 120 beats/minute. The nurse correctly interprets this rhythm as what? 1 Sinus tachycardia 2 Atrial fibrillation 3 Ventricular fibrillation 4 Ventricular tachycardia

Atrial fibrillation Atrial fibrillation is represented on the cardiac monitor by irregular R-R intervals and small fibrillatory (f) waves. There are no normal P waves because the atria are not contracting truly, just fibrillating. Sinus tachycardia is a sinus rate above 100 beats/minute with normal P waves. Ventricular fibrillation is seen on the ECG without a visible P wave, an unmeasurable heart rate, PR, or QRS, and the rhythm is irregular and chaotic. Ventricular tachycardia is seen as three or more premature ventricular contractions (PVCs) that have distorted QRS complexes with regular or irregular rhythm; the P wave usually is buried in the QRS complex without a measureable PR interval.

The nurse that is monitoring the electrocardiogram (ECG) of a patient with hyperthyroidism observes regular, sawtooth-shaped flutter waves with an atrial rate 250 beats/minute. How should the nurse document this pattern? 1 Sinus bradycardia 2 Sinus tachycardia 3 Atrial flutter 4 Atrial fibrillation

Atrial flutter Atrial flutter is an atrial tachydysrhythmia identified by flutter (F) waves, a sawtoothed pattern, with a 200-350 beats/minute atrial rate. In sinus bradycardia, the heart rate is less than 60 beats/minute, with regular rhythm and normal P waves. Sinus tachycardia is identified by 101 to 200 beats/minute, with regular rhythm and normal P waves. In atrial fibrillation, atrial rate is 350 to 600 beats/minute, with irregular rhythm, and fibrillatory (f) waves.

A patient's permanent pacemaker is failing to capture. The nurse recalls that the definition of failure to capture is when the electrical charge to the myocardium is insufficient to produce what cardiac activity? 1 Spontaneous atrial activity 2 Atrial or ventricular contraction 3 Excitability during the cardiac cycle 4 Spontaneous ventricular activity

Atrial or ventricular contraction Failure to capture occurs when the electrical charge to the myocardium is insufficient to produce atrial or ventricular contraction. Failure to sense occurs when the pacemaker fails to recognize spontaneous atrial or ventricular activity, and it fires inappropriately. This can result in the pacemaker firing during the excitable period of the cardiac cycle, resulting in ventricular tachycardia.

A patient is hospitalized for treatment of symptoms associated with a junctional escape rhythm, including a heart rate (HR) of 45 beats/min. What does the nurse expect to be prescribed for this patient?

Atropine

The nurse recalls that the heart's ability to initiate an impulse spontaneously and continuously is known as what property of heart cells?

Automaticity

The nurse expects to assess what heart rate in a patient with paroxysmal supraventricular tachycardia (PSVT)?

Between 150 and 220 beats/minute

A patient reports a new onset of jaw pain. The nurse obtains the following electrocardiogram (ECG) tracing. What action should the nurse take? 1 Contact the primary health care provider 2 Administer hydrocodone 3 Place the patient in a Trendelenburg position 4 Recognize the ECG changes as indicative of digitalis toxicity

Contact the primary health care provider The ECG tracing is showing ST elevation indicative of myocardial infarction (MI). The primary health care provider should be notified immediately so appropriate interventions can be prescribed. Morphine sulfate is the drug of choice for a patient experiencing an acute MI. Whenever possible, the patient experiencing an MI should be placed in a position promoting respirations. The Trendelenburg position inhibits respirations. Digoxin toxicity is characterized by ST segment depression, not elevation.

While ambulating, a patient's ECG tracing changes from normal sinus rhythm with a heart rate of 90/beats per minute to the following tracing. Which action should the nurse take?

Continue ambulating the patient

A patient's electrocardiogram (ECG) has changed from a normal sinus rhythm to the following rhythm. The nurse assesses the patient who was sleeping. The patient's respirations are 16 and unlabored, and the blood pressure has dropped from 110/70 to 104/68. What action should the nurse take?

Continue monitoring the patient

A patient has the following electrocardiogram (ECG) tracing. What action should the nurse take?

Continue to monitor the patient

The nurse recalls that cardiac cells enable the conduction system to start an electrical impulse. Which property of heart cells is defined as the ability of the heart to respond mechanically to an impulse?

Contractility

Which property of the cardiac cell aids in responding mechanically to an impulse?

Contractility

A patient reports a sudden onset of dizziness. The nurse records the following electrocardiogram (ECG) tracing. The nurse suspects that the dizziness is most likely a result of what?

Decreased cardiac output

Which action does flecainide have on the heart? 1 Decreases automaticity 2 Accelerates repolarization 3 Decreases impulse conduction 4 Reduces myocardial contractility

Decreases impulse conduction Flecainide is a class IC sodium channel blocker; it decreases impulse conduction in patients. Mexiletine is a class IB sodium channel blocker that accelerates repolarization. β-adrenergic blockers like esmolol decrease the automaticity of the sinoatrial node. Myocardial contractility is reduced with diltiazem, a calcium channel blocker.

A patient is hospitalized with an acute myocardial infarction. The patient's cardiac rhythm suddenly changes from sinus tachycardia to the following rhythm. What is the priority nursing action?

Defibrillate

The nurse prepares to defibrillate a patient in a life-threatening rhythm. The nurse recalls that defibrillation differs from synchronized cardioversion in which aspect?

Defibrillation is the treatment of choice for ventricular fibrillation

A patient in asystole is likely to receive which drug treatment?

Epinephrine and vasopressin

The nurse notes artifact on a patient's telemetry monitor. Which factors contribute to artifact?

Excessive hair under the electrode pads

A patient's electrocardiogram (ECG) shows prolonged PR interval, normal P waves, and normal QRS complexes. The patient is asymptomatic and has a normal heart rate and a regular rhythm. The nurse interprets the finding as which type of atrioventricular (AV) block?

First-degree AV block

A patient that reports dizziness and shortness of breath is admitted to the emergency department. The following is the patient's electrocardiogram (ECG) tracing. The nurse reviews the patient's plan of care and should question which item that is listed on the plan?

IV adenosine

The nurse assesses an unresponsive patient and reviews the patient's ECG tracing. The nurse determines that the patient is experiencing pulseless electrical activity (PEA). In addition to identifying the cause, what is the priority nursing action?

Initiate cardiopulmonary resuscitation (CPR)

A patient that is being tested for syncope has undergone the head-up tilt-test. After 30 minutes of testing, the patient's blood pressure and heart rate did not respond and no clinical symptoms were reproduced. The nurse anticipates that what medication will be given in a low dose intravenously (IV), to provoke a response?

Isoproterenol

The nurse reviews the following electrocardiogram (ECG) tracing. The nurse recognizes that the abnormal ECG finding is usually caused by what??

Myocardial ischemia

The patient is diagnosed with acute coronary syndrome (ACS). The nurse reviews the patient's electrocardiogram (ECG) and notes ST segment depression and T wave inversion. The ECG findings are indicative of what?

Myocardial ischemia

A patient with a heart rate of 180 beats/minute has a regular heart rhythm, normal P waves, and normal PR intervals. The nurse expects to see what QRS complex shape on the patient's ECG tracing?

Normal

The nurse observes the rhythm strip of a patient sitting up in bed and talking. The strip shows ventricular tachycardia (VT). What action should the nurse take?

Palpate the patient for a pulse.

The nurse is reviewing the electrocardiograms of four patients. What should the nurse conclude about these electrocardiograms?

Patient B has accelerated junctional rhythm

The nurse is reviewing prescriptions of four patients. What does the nurse infer from this review?

Patient C has junctional escape rhythm

The nurse reviews the electrocardiogram of four patients. What should the nurse conclude from these findings?

Patient D: There are recurring regular, sawtooth-shaped flutter waves

The ECG monitor of a patient in the cardiac care unit after myocardial infarction (MI) indicates ventricular fibrillation. What should be the nurse's immediate action?

Perform cardiopulmonary resuscitation (CPR)

The electrocardiogram (ECG) of a patient indicates P waves that are hidden in the preceding T waves and normal QRS complexes. The nurse recognizes that the patient is experiencing what condition?

Premature atrial contractions

The nurse reviews a patient's electrocardiogram (ECG) tracing and notes a heart rate of 82 and an irregular rhythm. How should the nurse interpret the findings?

Premature atrial contractions

A patient's electrocardiogram (ECG) tracing shows wide and distorted QRS complexes. How should the nurse interpret the finding? 1 Sinus tachycardia 2 Ventricular fibrillation 3 Junctional dysrhythmias 4 Premature ventricular contractions

Premature ventricular contractions Premature ventricular contractions are caused by premature impulses originating from the ventricles of the heart and not from the sinoatrial node. This causes the QRS complex to be wide and distorted. The QRS wave appears normal in patients with sinus tachycardia. The QRS wave is not measurable in the electrocardiogram of a patient with ventricular fibrillation. The QRS complex will be normal in the electrocardiogram of patient with junctional dysrhythmias.

The nurse is monitoring a patient on a wireless electrocardiogram (ECG) monitor. Which observation is a cause for concern? 1 Upright P wave 2 Flat ST segment 3 Prolonged QT interval 4 Upright T wave

Prolonged QT interval Prolonged QT interval is a cause for concern. QT disturbance may be caused by drugs, electrolyte imbalances, and changes in heart rate. Upright P wave, flat ST segment, and upright T wave are normal findings.

The nurse is analyzing patients' ECG tracings. Which patient is at greatest risk for a stroke?

RS-FFFF

A patient is experiencing atrial flutter. The nurse anticipates that what treatment will be included in the patient's plan of care?

Radiofrequency catheter ablation

Which ECG characteristic is consistent with a diagnosis of ventricular tachycardia (VT)?

Rate 200 beats/minute; P wave not visible

The nurse suspects that a patient is experiencing myocardial infarction (MI). Which component of the patient's electrocardiogram (ECG) is most important for the nurse to analyze to make this determination?

ST segment

The nurse reviews a patient's electrocardiogram (ECG) tracing. How should the nurse interpret the finding?

Sinus bradycardia

A patient's electrocardiogram (ECG) shows a heart rate of 150 beats/minute and a normal P wave preceding each QRS complex. How should the nurse interpret the finding?

Sinus tachycardia

The nurse assesses a patient and notes a temperature of 101.6° F. Which type of dysrhythmia is associated with a fever?

Sinus tachycardia

The nurse has obtained a rhythm strip from a patient's telemetry monitor. Which description of the electrocardiogram (ECG) is correct?

Sinus tachycardia

Which statement is true regarding the role of the autonomic nervous system in impulse formation? 1 Stimulation of the parasympathetic nerves increases cardiac contractility. 2 Stimulation of the vagus nerve causes a decreased rate of firing of the sinoatrial (SA) node. 3 Stimulation of the sympathetic nerves decreases atrioventricular (AV) node impulse conduction. 4 Stimulation of the vagus nerve causes increased impulse conduction of the atrioventricular (AV) node.

Stimulation of the vagus nerve causes a decreased rate of firing of the sinoatrial (SA) node The autonomic nervous system plays an important role in the rate of impulse formation, the speed of conduction, and the strength of cardiac contraction. Stimulation of the vagus nerve causes a decreased rate of firing of the sinoatrial node. Stimulation of the parasympathetic system decreases cardiac contractility. Stimulation of the sympathetic nerves increases atrioventricular node impulse conduction. Stimulation of the vagus nerve decreases impulse conduction of the atrioventricular node. Vagus nerve fibers of the parasympathetic nervous system and nerve fibers of the sympathetic nervous system are the components of the autonomous nervous system that affect the heart rate.

A patient is hospitalized following a 3-day history of heart palpitations and dizziness. The patient's electrocardiogram (ECG) shows the following rhythm. The nurse identifies that the patient is at risk for what?

Stroke

A patient develops atrial flutter with a rapid ventricular response. The nurse anticipates that what treatment will be prescribed?

Synchronized cardioversion

A patient with paroxysmal supraventricular tachycardia (PSVT) that is receiving intravenous adenosine becomes hemodynamically unstable. The nurse expects what to be included in the patient's immediate treatment plan? 1 β-adrenergic blocker 2 Calcium channel blocker 3 Catheter ablation therapy 4 Synchronized cardioversion

Synchronized cardioversion Paroxysmal supraventricular tachycardia is a dysrhythmia starting in an ectopic focus anywhere above the bifurcation of the bundle of His. The standard drug of choice to treat paroxysmal supraventricular tachycardia is intravenous (IV) adenosine. Sometimes the drug therapy is ineffective and the patient becomes hemodynamically unstable. For patients who are unresponsive to treatment, synchronized cardioversion is used. Synchronized cardioversion is low energy shock, which uses a sensor to deliver electricity that is synchronized with the peak of the QRS complex. Drug therapy is not effective for such patients. β -adrenergic blockers and calcium channel blockers do not improve paroxysmal supraventricular tachycardia. Catheter ablation therapy is used in patients with Wolff-Parkinson-White syndrome who have recurring paroxysmal supraventricular tachycardia (PSVT).

The nurse reviews the electrocardiogram (ECG) tracing of a patient with an electrolyte imbalance and expects to find a disturbance in which waveform?

T wave

Which statement describes the electrical activity of the heart represented by the PR interval on an electrocardiogram (ECG)?

The length of time for the electrical impulse to travel from the sinoatrial (SA) node to the Purkinje fibers

A patient's assessment findings include dizziness, shortness of breath, heart palpitations, and paroxysmal supraventricular tachycardia (PSVT). The nurse obtains a prescription for adenosine. Which statement is true about the medication?

The medication decreases conduction through the AV node.

A patient arrives in the emergency room with indigestion, shortness of breath, and back pain. The nurse reviews the results of the patient's 12-lead electrocardiogram (ECG) and notes ST elevation in leads II, III, and AVF. How should the nurse interpret the findings?

The patient has acute injury to the right coronary artery.

A patient's electrocardiogram (ECG) tracing has changed from sinus tachycardia (ST) to the following rhythm. What should the nurse conclude from the ECG finding?

The patient is experiencing a myocardial infarction

What does the T wave in an electrocardiogram (ECG) represent?

Time for ventricular repolarization

A patient is hospitalized with heart failure. The patient has the following electrocardiogram (ECG) tracing, is experiencing chest pain, shortness of breath, and has a blood pressure of 70/40. The nurse anticipates that what will be included on the patient's plan of care?

Transcutaneous pacing

A patient is in ventricular fibrillation, and cardiopulmonary resuscitation (CPR) is in progress. What is the first step the nurse should take?

Turn on the device

A patient is scheduled to receive IV adenosine. What action should the nurse take while administering the medication?

Use an injection site as close to the heart as possible

Defibrillation is indicated for which dysrhythmia?

Ventricular fibrillation

The nurse recognizes that which cardiac dysrhythmia is life-threatening and necessitates immediate intervention?

Ventricular fibrillation

Which type of arrhythmia is associated with the absence of P waves on an electrocardiogram (ECG)?

Ventricular fibrillation


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