NCLEX Cardiac dysrhythmia Questions

NCLEX Cardiac dysrhythmia Questions Juls225_Top creator on Quizlet Save Myocardial infarction NCLEX 18 terms alisharosehorn Preview Myocardial Infarction (MI) NCLEX Q...19 terms florahill10Preview HTN, angina, MI, Atrial Fib Question...Teacher 33 terms mcquigleykkkk Preview NCLEX 22 terms Em A patient admitted with syncope has continuous EKG monitoring. An examination of the rhythm strip reveals the following: atrial rate 74 bpm and regular; ventricular rate 62 bpm and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. The priority nursing intervention would be to...

• give epinephrine 1 mg IV push
• prepare for synchronized cardioversion
• observe for symptoms of hypotension or angina
• apply transcutaneous pacemaker pads on the patient
• observe for symptoms of hypotension or angina

Rationale: The rhythm is a second-degree atrioventricular (AV) block, type I (i.e., Mobitz I or Wenckebach heart block). It is characterized by a gradual lengthening of the PR interval. Type I AV block is usually a result of myocardial ischemia or infarction. It is typically transient and well tolerated. The nurse should assess for bradycardia, hypotension, and angina. The symptomatic patient may need atropine or a temporary pacemaker The EKG monitor of a patient in the cardiac care unit after an MI shows ventricular bigeminy with a rate of 50 bpm. The nurse would...

• perform defibrillation
• administer IV amiodarone
• prepare for temporary pacemaker insertion
• assess the patient's response to the dysrhythmias
• assess the patient's response to the dysrhythmias

Rationale: A premature ventricular contraction (PVC) is a contraction originating in an ectopic focus in the ventricles. When every other beat is a PVC, the rhythm is called ventricular bigeminy. PVCs are usually a benign finding in patients with a normal heart. In patients with heart disease, PVCs may reduce the cardiac output and precipitate angina and heart failure, depending on the frequency. Because PVCs in coronary artery disease (CAD) or acute myocardial infarction indicate ventricular irritability, the patient's physiologic response to PVCs must be monitored.Assessing the patient's hemodynamic status is important for deciding the need for drug therapy

In the patient with supraventricular tachycardia, which assessment indicates decreased cardiac output?

• hypertension and dyspnea
• chest pain and palpitations
• abdominal distention and tachypnea
• bounding pulses and a systolic murmur
• chest pain and palpitations

Rationale: Manifestations of decreased cardiac output in the patient with supraventricular tachycardia include hypotension, angina, palpitations, and dyspnea The nurse prepares a patient for synchronized cardioversion knowing that cardioversion differs from defibrillation in that...

• defibrillation delivers a lower dose of electrical energy
• cardioversion is a treatment for atrial bradydysrhythmias
• defibrillation is synchronized to deliver a shock during the QRS complex
• patients should be sedated if cardioversion is done on a nonemergency basis
• patients should be sedated if cardioversion is done on a nonemergency basis

Rationale: Synchronized cardioversion is the therapy of choice for patients with hemodynamically unstable ventricular or supraventricular tachydysrhythmias. A synchronized circuit in the defibrillator delivers a countershock that is programmed to occur on the R wave of the QRS complex of the electrocardiogram. The synchronizer switch must be turned on when cardioversion is planned. The procedure for synchronized cardioversion is the same as for defibrillation with a few exceptions: If synchronized cardioversion is done on a nonemergency basis, the patient is sedated before the procedure, and the initial energy needed for synchronized cardioversion is less than the energy needed for defibrillation Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver? (select all that apply)

• avoid or limit air travel
• take and record a daily pulse rate
• obtain and wear a medic alert ID device at all times
• avoid lifting arm on the side of the pacemaker above the shoulder
• do not use a microwave oven because it interferes with pacemaker function
• take and record a daily pulse rate
• obtain and wear a medic alert ID device at all times
• avoid lifting arm on the side of the pacemaker above the shoulder

Rationale: Pacemaker discharge teaching should include: Air travel is not restricted. The patient should tell airport security of the presence of a pacemaker because it may set off the metal detector. A hand-held screening wand should not pass directly over the pacemaker. Manufacturer information varies about the effect of metal detectors on pacemaker function. The patient should monitor the pulse and tell the HCP if it drops below a predetermined rate. The patient should have and wear a Medic Alert ID device at all times. The patient must avoid lifting the arm on the pacemaker side above the shoulder until approved by the HCP. Microwave ovens are safe to use. They do not interfere with pacemaker function.

Important teaching for the patient scheduled for a radiofrequency catheter ablation procedure includes explaining that...

• ventricular bradycardia may be induced and treated during the procedure
• catheter will be placed in both femoral arteries to allow double-catheter use
• the procedure will destroy areas of the conduction system that are causing rapid heart rhythms
• general anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences
• the procedure will destroy areas of the conduction system that are causing rapid heart rhythms

Rationale: Radiofrequency catheter ablation therapy involves the use of electrical energy to "burn" or ablate areas of the conduction system as definitive treatment of tachydysrhythmias. Terms (6) Hide definitions