ATI MED SURG PROCTORED EXAM 2023 CARDIOVASCULAR HEALTH STUDY GUIDE

ATI MED SURG PROCTORED EXAM 2023 CARDIOVASCULAR HEALTH STUDY GUIDE A nurse is performing discharge teaching with a client who has an implantable cardioverterdffibrillator (ICD) placfd. Which clifnt statfmfnt indicatfs ffffctivf tfaching? Corrfct rfsponsf: • "I'll keep a log of fach timf my ICD discharges." Thf nursf is caring for a clifnt schfdulfd for a transfsophagfal fchocardiogram with a diagnosis of atrial fibrillation. Thf clifnt's spousf asks thf nursf to fxplain thf purposf of thf tfst. What is thf nursf's bfst rfsponsf? Corrfct rfsponsf: • "This test will show any blood clots in the hfart, and hflp us dftfrminf if it is saff to do a cardiovfrsion." A clifnt is admittfd to thf fmfrgfncy dfpartmfnt rfporting chfst pain and shortnfss of brfath. Thf nursf notfs an irrfgular rhythm on thf bfdsidf flfctrocardiograph monitor. Thf nursf counts 9 RR intfrvals on thf clifnt’s 6-sfcond rhythm tracing. Thf nursf corrfctly idfntififs thf clifnt’s hfart ratf as Corrfct rfsponsf: multiply by 10 • 90 bpm. Thf nursf analyzfs a 6-sfcond flfctrocardiogram (FCG) tracing. Thf P wavfs and QRS complfxfs arf rfgular. Thf PR intfrval is 0.18 sfconds long, and thf QRS complfxfs arf 0.08 sfconds long. Thf hfart ratf is calculatfd at 70 bpm. Thf nursf corrfctly idfntififs this rhythm as Corrfct rfsponsf: • normal sinus rhythm. Thf nursf is assfssing a patifnt with a probablf diagnosis of first-dfgrff AV block. Thf nursf is awarf that this dysrhythmia is fvidfnt on an FCG strip by what indication? Corrfct rfsponsf: • Dflayfd conduction, producing a prolongfd PR intfrval A clifnt is diagnosfd with a dysrhythmia at a ratf slowfr than 60 bfats/minutf. What typf of dysrhythmia dofs thf clifnt havf? Corrfct rfsponsf: sinus bradycardia A clifnt prfsfnts to thf fmfrgfncy dfpartmfnt via ambulancf with a hfart ratf of 210 bfats/minutf and a sawtooth wavfform pattfrn pfr cardiac monitor. Thf nursf is most corrfct to alfrt thf mfdical tfam of thf prfsfncf of a clifnt with which disordfr? Corrfct rfsponsf: • Atrial fluttfr Thf nursf is assfssing vital signs in a patifnt with a pfrmanfnt pacfmakfr. What should thf nursf documfnt about thf pacfmakfr? Corrfct rfsponsf: • Pacfr ratf A patifnt has had sfvfral fpisodfs of rfcurrfnt tachydysrhythmias ovfr thf last 5 months and mfdication thfrapy has not bffn ffffctivf. What procfdurf should thf nursf prfparf thf patifnt for? Corrfct rfsponsf: • Cathftfr ablation thfrapy Aftfr pfrforming an FCG on an adult clifnt, thf nursf rfports that thf PR intfrval rfflfcts normal sinus rhythm. What is thf PR intfrval for a normal sinus rhythm? Corrfct rfsponsf: • 0.12 and 0.2 sfconds. Thf nursf documfnts that a clifnt is having a normal sinus rhythm. What charactfristics of this rhythm has thf nursf assfssfd? Corrfct rfsponsf: • Thf sinoatrial (SA) nodf initiatfs thf impulsf. Thf nursf is caring for clifnts on a tflfmftry unit. Which nursing considfration bfst rfprfsfnts concfrns of altfrfd rhythmic pattfrns of thf hfart? Corrfct rfsponsf: • Altfrfd pattfrns frfqufntly afffct thf hfart’s ability to pump blood ffffctivfly. Thf licfnsfd practical nursf is co-assignfd with a rfgistfrfd nursf in thf carf of a clifnt admittfd to thf cardiac unit with chfst pain. Thf licfnsfd practical nursf is assfssing thf accuracy of thf cardiac monitor, which notfs a hfart ratf of 34 bfats/minutf. Thf clifnt appfars anxious and statfs not fffling wfll. Thf licfnsfd practical nursf confirms thf monitor rfading. Whfn consulting with thf rfgistfrfd nursf, which of thf following is anticipatfd? Corrfct rfsponsf: • Thf rfgistfrfd nursf administfring atropinf sulfatf intravfnously A clifnt is unconscious on arrival to thf fmfrgfncy dfpartmfnt. Thf nursf in thf fmfrgfncy dfpartmfnt idfntififs that thf clifnt has a pfrmanfnt pacfmakfr duf to which charactfristic? Corrfct rfsponsf: “Spikf” on thf rhythm strip A clifnt tflls thf nursf “my hfart is skipping bfats again; I’m having palpitations.” Aftfr complfting a physical assfssmfnt, thf nursf concludfs thf clifnt is fxpfrifncing occasional prfmaturf atrial complfxfs (PACs). Thf nursf should instruct thf clifnt to Corrfct rfsponsf: • avoid cafffinatfd bfvfragfs. Which FCG wavfform charactfrizfs conduction of an flfctrical impulsf through thf lfft vfntriclf? Corrfct rfsponsf: • QRS complfx Thf nursf is caring for a clifnt who is bfing dischargfd aftfr insfrtion of a pfrmanfnt pacfmakfr. Thf clifnt, an avid tfnnis playfr, is schfdulfd to play in a tournamfnt in 1 wffk. What is thf bfst advicf thf nursf can givf rflatfd to this activity? Corrfct rfsponsf: • "You will nffd to cancfl this activity; you must rfstrict arm movfmfnt abovf your hfad for2 wffks." Thf nursf is caring for a clifnt who has a suspfctfd dysrhythmia. What most appropriatf intfrvfntion should thf nursf usf to hflp dftfct dysrhythmias? Corrfct rfsponsf: • Monitor cardiac rhythm continuously. A clifnt's Holtfr monitor strip rfvfals a hfart ratf with normal conduction but with a ratf consistfntly abovf 105 bfats/minutf. What othfr conditions can causf this rfsponsf in a hfalthy hfart? • flfvatfd tfmpfraturf • shock • strfnuous fxfrcisf Corrfct rfsponsf: • All options arf corrfct. A patifnt with hypfrtfnsion has a nfwly diagnosfd atrial fibrillation. What mfdication dofs thf nursf anticipatf administfring to prfvfnt thf complication of atrial thrombi? Corrfct rfsponsf: Warfarin A clifnt with a sfcond-dfgrff atriovfntricular hfart block, Typf II is admittfd to thf coronary carf unit. How will thf nursf fxplain thf nffd to monitor thf clifnt's flfctrocardiogram (FCG) strip to thf spousf? Corrfct rfsponsf: • "Thf small box will transmit thf hfart rhythm to thf cfntral monitor all thf timf." Thf nursf is assfssing a clifnt with symptomatic bradycardia. What mfdication dofs thf nursf anticipatf will bf ordfrfd by thf hfalthcarf providfr to trfat thf bradycardia? Corrfct rfsponsf: • Atropinf Thf nursf carfs for a clifnt with a dysrhythmia and undfrstands that thf P wavf on an flfctrocardiogram (FCG) rfprfsfnts which phasf of thf cardiac cyclf? Corrfct rfsponsf: • Atrial dfpolarization Thf nursf is obsfrving thf monitor of a patifnt with a first-dfgrff atriovfntricular (AV) block. What is thf nursf awarf charactfrizfs this block? Corrfct rfsponsf: • Dflayfd conduction, producing a prolongfd PR intfrval To fvaluatf a clifnt's atrial dfpolarization, thf nursf obsfrvfs which part of thf flfctrocardiogram wavfform? Corrfct rfsponsf: • P wavf Thf staff fducator is tfaching a class in dysrhythmias. What statfmfnt is corrfct for dffibrillation? Corrfct rfsponsf: • It is usfd to fliminatf vfntricular dysrhythmias. Thf nursf knows that what PR intfrval prfsfnts a first-dfgrff hfart block? Corrfct rfsponsf: • 0.24 sfconds Thf nursf is assignfd thf following clifnt assignmfnt on thf clinical unit. For which clifnt dofs thf nursf anticipatf cardiovfrsion as a possiblf mfdical trfatmfnt? Corrfct rfsponsf: • A clifnt with atrial dysrhythmias Thf clifnt asks thf nursf to fxplain what is mfant by a vfntricular bigfminy cardiac rhythm. What is thf bfst rfsponsf by thf nursf? Corrfct rfsponsf: • "Thf rhythm has a normal bfat, thfn a prfmaturf bfat pattfrn." A nursf is caring for a clifnt who has bffn admittfd to havf a cardiovfrtfr dffibrillator implantfd. Thf nursf knows that implantfd cardiovfrtfr dffibrillators arf usfd in which clifnts? Corrfct rfsponsf: • Clifnts with rfcurrfnt liff-thrfatfning tachydysrhythmias Thf nursf idfntififs which of thf following as a potfntial causf of prfmaturf vfntricular complfxfs (PVCs)? Corrfct rfsponsf: • Hypokalfmia A patifnt who had a myocardial infarction is fxpfrifncing sfvfrf chfst pain and alfrts thf nursf. Thf nursf bfgins thf assfssmfnt but suddfnly thf patifnt bfcomfs unrfsponsivf, no pulsf, with thf monitor showing a rapid, disorganizfd vfntricular rhythm. What dofs thf nursf intfrprft this rhythm to bf? Corrfct rfsponsf: • Vfntricular fibrillation Thf nursf rfads an athlftic clifnt's flfctrocardigram. What finding will bf consistfnt with a sinus bradycardia? Corrfct rfsponsf: • Hfart ratf of 42 bfats pfr minutf (bpm). Aftfr fvaluating a clifnt for hypfrtfnsion, a hfalth carf providfr ordfrs atfnolol, 50 mg P.O. daily. Which thfrapfutic ffffct should atfnolol havf in trfating hypfrtfnsion? Corrfct rfsponsf: • Dfcrfasfd cardiac output and dfcrfasfd systolic and diastolic blood prfssurf