Chapter 38: Nursing Management: Dysrhythmias Lewis et al.: Medical-Surgical Nursing in Canada, 3rd Edition | Questions and Answers with complete solution

Patient cantered approach - care that is focused on the whole person as a unique individual and not just their illness or disease. patient safety - is a critical part of patient-centred care, the nurse must be able to assess and manage situations that may compromise patient safetyANS: B The PR interval represents depolarization of the atria, atrioventricular (AV) node, bundle of His, bundle branches, and Purkinje fibres, up to the point of depolarization of the ventricular cells. PTS: 1 DIF: Cognitive Level: Comprehension REF: page 951 OBJ: 2 TOP: Nursing Process: Assessment MSC: CRNE: CH-8 - 1. In analyzing a patient's electrocardiogram (ECG) rhythm strip, the nurse uses the knowledge that the time of the conduction of an impulse through the Purkinje fibres is represented by which of the following changes? a. P wave b. PR interval c. QT interval d. QRS complex ANS: B The normal duration of a PR interval is 0.12 to 0.20 seconds. PTS: 1 DIF: Cognitive Level: Comprehension REF: page 955, Table 38-2 OBJ: 2 TOP: Nursing Process: Assessment MSC: CRNE: CH-8 - 2. Which of the following is an abnormal ECG value for a PR interval duration? a. 0.6 second b. 0.12 second c. 0.24 secondd. 0.30 second ANS: C If the sinoatrial node fails to discharge, the junction will automatically discharge at the normal junctional rate of 40 to 60 beats/min. PTS: 1 DIF: Cognitive Level: Comprehension REF: page 961 OBJ: 3 TOP: Nursing Process: Assessment MSC: CRNE: CH-8 - 3. A patient has a sinus arrest with a junctional escape rhythm. What would the nurse expect the patient's pulse rate to be? a. 15 to 20 beats/min b. 20 to 40 beats/min c. 40 to 60 beats/min d. 60 to 100 beats/min ANS: D The patient has sinus tachycardia, which can be caused by multiple stressors such as pain, dehydration, or myocardial ischemia. Further assessment is needed before determining the treatment. PTS: 1 DIF: Cognitive Level: Analysis REF: pages 958-959 OBJ: 2 TOP: Nursing Process: Implementation MSC: CRNE: CH-22 - 4. A patient who is complaining of a "racing" heart and nervousness comes to the emergency department. The patient's blood pressure (BP) is 102/68 mm Hg. The nurse places the patient on a cardiac monitor and obtains the following ECG tracing: Which action should the nurse take next? a. Have the patient perform the Valsalva manoeuvre. b. Prepare to administer -blocker medication to slow the heart rate. c. Get ready to perform electrical cardioversion. d. Obtain further information about possible causes for the heart rate. ANS: A