NUR336 Evolve: Chapter 34 - Cardiac Rhythms and Dysrhythmias
The nurse is teaching a patient about self-management to prevent dysrhythmias caused by premature beats and ectopic rhythms. Which statement made by the patient indicates a need for further teaching?
"I have to drink coffee twice daily and other energy drinks to stay active."
The nurse is teaching a patient with a new permanent pacemaker. Which statement by the patient indicates a need for further discharge education?
"I no longer need my heart pills."
The nurse is assisting with resuscitation efforts on a patient in the ICU when the family tearfully comes to the door and requests to be in the room with their loved one. Which response by the nurse is best?
"If you feel you need to be present for your loved one, remain to the side and I will answer your questions later."
In teaching patients at risk for bradydysrhythmias, what information does the nurse include?
"Use a stool softener."
The nurse is teaching a patient about the synchronous demand pacemaker that has just been implanted for an episode of complete heart block. Which statement indicates the patient understands the teaching?
"When my pulse is less than the set rate, the pacemaker stimulates my heart to beat."
The nurse is caring for a patient with heart rate of 143 beats/min. For which manifestations does the nurse observe?
-Palpitations. -Chest discomfort. -Hypotension.
A patient has episodes of ventricular tachycardia. Which medication does the nurse anticipate administering?
Amiodarone.
A patient is prescribed adenosine drug therapy to convert supraventricular tachycardia to normal sinus rhythm. Which parameter should the nurse monitor in this patient?
Bradycardia.
While the health care provider is at the bedside, the patient's heart rate increases from 82 to 176 beats/min and supraventricular tachycardia is noted on the cardiac monitor. The provider decides to do immediate carotid sinus massage. What is the nurse's role in this situation?
Bring a defibrillator and resuscitative equipment to the bedside.
Which condition is a result of a hypereffective heart in a well-conditioned athlete?
Bradycardia.
Which statement correctly differentiates cardioversion from defibrillation?
Cardioversion delivers a synchronized shock for ventricular tachycardia or supraventricular tachycardia; it is not useful in ventricular fibrillation because all electrical activity is disorganized with no ability to synchronize.
The nurse is teaching a patient with a dysrhythmia to eat potassium-containing foods. Which food does the nurse suggest the patient include in the diet?
Strawberries.
Which statement best explains why tachydysrhythmias such as supraventricular tachycardia lead to chest pain?
The diastole is shortened, and coronary perfusion is decreased.
How does the nurse recognize that atropine has produced a positive outcome for the patient with bradycardia?
The monitor shows an increase in heart rate.
The nurse is teaching a patient who has been diagnosed with atrial fibrillation. Which food item does the nurse teach the patient to avoid?
Caffeine.
The bedside cardiac monitor alarms and the patient suddenly becomes limp and unresponsive with no carotid pulse. What is the first thing the nurse does?
Call for the Rapid Response Team.
A patient with atrial fibrillation with rapid ventricular response has received medication to slow the ventricular rate. The pulse is now 88 beats/min. For which additional therapy does the nurse plan?
Anticoagulation.
The patient has had asymptomatic sinus bradycardia with a rate of 56 beats/min. The nurse notes the rate has dropped to 46 beats/min. What action does the nurse take?
Assess blood pressure, skin color, and moisture.
A 78-year-old patient has recently been prescribed a daily dose of diltiazem for atrial fibrillation. Her daughter calls to report that she is experiencing weakness and confusion for the past couple of days. How does the nurse respond to the daughter's concern?
"Has your mother experienced any dizziness during this time?"
The nurse is caring for a patient on a telemetry unit with a regular heart rhythm and rate of 60 beats/min; a P wave precedes each QRS complex, and the PR interval is 0.24 second. Additional vital signs are as follows: blood pressure 118/68, respiratory rate 16, and temperature 98.8° F. All of these medications are available on the medication record. What action does the nurse take?
Continue to monitor.
The nurse is caring for a patient with acute coronary syndrome (ACS) and atrial fibrillation who has a new prescription for metoprolol. Which monitoring is essential when administering the medication?
Heart rate.
In caring for a patient following an acute myocardial infarction, what is the greatest priority when planning care?
Monitoring for increased frequency of premature ventricular contractions.
The nurse is assisting a nurse practitioner with the wellness examination of a high school athlete and notes the cardiac rhythm strip has all the characteristics of normal sinus rhythm, except it is irregular. There is a pattern to the irregularity associated with the patient's breathing. How does the nurse respond to this finding?
Nothing, as this is a healthy rhythm.
The AED indicates the patient is in ventricular asystole. After checking for a carotid pulse and finding none, the nurse certified in basic life support knows the priority action is to
Start compressions.
Which cardiac rhythm typically deteriorates into ventricular fibrillation?
Ventricular tachycardia.
