Cardiac Care

The nurse is delegating obtaining a 12-lead electrocardiogram to nursing assistive personnel (NAP). Which of the following would be appropriate direction to give the NAP?

"Let me know if the patient has any complaints of chest pain."

The nurse shows the student a patient's normal sinus rhythm on the cardiac monitor. The nurse asks the student which waveform represents ventricular depolarization. What is the correct response?

"The QRS complex."

Two students are reviewing the electrical conduction system of the heart. Which statement would require correction?

"The T wave reflects atrial repolarization."

A patient with chest pain arrives in the emergency department. The staff hurries to perform a 12-lead electrocardiogram (ECG). The patient appears anxious and asks, "Why are all of these wires being hooked up to me?" Which of the following would be the best response by the nurse?

"This is an electrocardiogram which will provide information about your heart and help us to develop the best plan of care for you."

The nurse informs the patient that she needs to wash the patient's chest area with soap and water prior to applying the ECG electrodes. The patient states, "Why? I took a bath this morning." What is the nurse's best response?

"This will help the electrodes to adhere better and provide a clearer reading."

The nurse manager is preparing an in-service for the staff on measures to prevent alarm fatigue and reduce false alarms. What information should be included? (Select all that apply.)

- Only patients with clinical indications for monitoring should be monitored. - Alarm fatigue develops when a person is exposed to an excessive number of alarms.

The nurse is working on a postoperative unit. For which patient(s) would the nurse anticipate continuous cardiac monitoring? (Select all that apply.)

-A patient who was resuscitated in the operating room. -A patient with a newly implanted defibrillator. -A patient with a history of atrioventricular block.

The nurse delegated application of continuous monitoring of an adult patient to the telemetry technician. Which observations would be appropriate for the technician to report to the nurse? (Select all that apply.)

-Alarming of the telemetry monitor. -Patient complaints of shortness of breath. -A blood pressure reading of 90/56.

A patient arrives in the emergency department complaining of chest pain. Which implementations are reflective of appropriate care for the cardiac patient? (Select all that apply.)

-Creating a list of the patient's current medications, including antiarrhythmics. -Washing the area for electrode placement with soap and water and drying with gauze. -Obtaining an ordered 12-lead electrocardiogram within 10 minutes - Assessing the patient's ability to lie still and patient's pain on acuity scale.

The nurse is providing information regarding a 12-lead electrocardiogram (ECG). Which of the following would be accurate? (Select all that apply.)

-The 12-lead ECG provides a snapshot of the waveforms from 12 different views of the heart. -The 12-lead ECG can help determine which part of the heart sustained damage.

Nursing students are reviewing information regarding cardiac functioning. Which of the following reflects accurate information? (Select all that apply.)

-The ventricles are relaxed during diastole. -S1 ("lub") is created by the closing of the mitral and tricuspid valves. -The aortic and pulmonic valves closing create S2 ("dub"). -A dysrhythmia is a disturbance in the electrical impulse of the heart rhythm.

The nurse is giving shift report on four patients. The nurse receiving report would expect which patient to have continuous cardiac monitoring?

A patient with a medical diagnosis of heart failure with abnormal lung sounds.

The nurse in the intensive care unit has a new patient admission. The nurse applies a three-lead system to the patient's chest for continuous cardiac monitoring. Which lead placement is correct?

Black at second intercostal space on left, white on second intercostal space on right, red on left lower chest (left leg).

The nurse notices that the patient's waveform tracing on the cardiac monitor has a lot of artifact. What action is most appropriate to reduce artifact?

Ensure electrodes/leads are securely placed and encourage patient to lie still.

The nurse is going to assess an adult patient's apical pulse at the point of maximal impulse (PMI). Where will the nurse place the stethoscope?

Fifth intercostal space, left midclavicular line.

The telemetry nurse is observing the cardiac monitor tracings of four patients. Which monitor tracing reflects normal sinus rhythm?

Normal sinus rhythm is regular, at a rate of 60 to 99 bpm with a normal QRST complex. The other rhythms depicted are sinus tachycardia (rate 100 to 180), sinus bradycardia (rate less than 60), and premature ventricular contractions (an irregular rhythm followed by compensatory pause).

Test

Test

The nurse manager of a busy cardiac care unit is aware of the dangers of alarm fatigue. Which action would help reduce false alarms?

The nurse changes the alarm parameters according to orders and patient condition.

A patient arrives in the emergency department. For which indication would the nurse anticipate a 12-lead electrocardiogram will be ordered?

The patient complains of his heart "racing" and "fluttering."

The ECG machine is reading "ERROR—Check lead placement." Which of the following requires correction?

V2 at fifth intercostal space midclavicular line

The nurse is applying continuous electronic monitoring using a five-lead system. Which of the following describes correct lead placement?

White on right arm, black on left arm, red on left leg, green on right leg, brown on chest at a V lead location.