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Brunner and Suddarths Textbook of Medical Surgical Nursing- Chapter 26: Management of Patients with Dysrhythmias and Conduction Problems

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A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a patient's cardiac function in what way? Exacerbating an existing dysrhythmia Initiating a new dysrhythmia Resolving ventricular tachycardia Increasing the heart rate - correct answerExacerbating an existing dysrhythmia Initiating a new dysrhythmia Resolving ventricular tachycardia Increasing the heart rate**** Feedback: Stimulation of the sympathetic system increases heart rate. This phenomenon is known as positive chronotropy. It does not influence dysrhythmias.

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Brunner and Suddarths Textbook of Medical Surgical
Nursing- Chapter 26: Management of Patients with
Dysrhythmias and Conduction Problems
A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a
patient's cardiac function in what way?



Exacerbating an existing dysrhythmia

Initiating a new dysrhythmia

Resolving ventricular tachycardia

Increasing the heart rate - correct answerExacerbating an existing dysrhythmia

Initiating a new dysrhythmia

Resolving ventricular tachycardia

Increasing the heart rate****



Feedback: Stimulation of the sympathetic system increases heart rate. This phenomenon is known as
positive chronotropy. It does not influence dysrhythmias.



A group of nurses are participating in orientation to a telemetry unit. What should the staff educator tell
this class about ST segments?



They are the part of an ECG that reflects systole.

They are the part of an ECG used to calculate ventricular rate and rhythm.

They are the part of an ECG that reflects the time from ventricular depolarization through
repolarization.

They are the part of an ECG that represents early ventricular repolarization. - correct answerThey are
the part of an ECG that reflects systole.



They are the part of an ECG used to calculate ventricular rate and rhythm.

, They are the part of an ECG that reflects the time from ventricular depolarization through
repolarization.



They are the part of an ECG that represents early ventricular repolarization.***



Feedback: ST segment is the part of an ECG that reflects the end of the QRS complex to the beginning of
the T wave. The part of an ECG that reflects repolarization of the ventricles is the T wave. The part of an
ECG used to calculate ventricular rate and rhythm is the RR interval. The part of an ECG that reflects the
time from ventricular depolarization through repolarization is the QT interval.



A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is
pulseless, the nurse should prepare for what intervention?



Defibrillation

ECG monitoring

Implantation of a cardioverter defibrillator

Angioplasty - correct answerDefibrillation***

ECG monitoring

Implantation of a cardioverter defibrillator

Angioplasty



Feedback: Any type of VT in a patient who is unconscious and without a pulse is treated in the same
manner as ventricular fibrillation: Immediate defibrillation is the action of choice. ECG monitoring is
appropriate, but this is an assessment, not an intervention, and will not resolve the problem. An ICD and
angioplasty do not address the dysrhythmia.



A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse should
describe what aspect of this treatment?



Peeling away the area of endocardium responsible for the dysrhythmia



Using electrical shocks directly to the endocarduim to eliminate the source of dysrhythmia

, Using highfrequency sound waves to eliminate the source of dysrhythmia



Using a cooled probe to eliminate the source of dysrhythmia - correct answerPeeling away the area of
endocardium responsible for the dysrhythmia



Using electrical shocks directly to the endocarduim to eliminate the source of dysrhythmia



Using highfrequency sound waves to eliminate the source of dysrhythmia



Using a cooled probe to eliminate the source of dysrhythmia*****



Feedback: Cryoablation therapy involves using a cooled probe to create a small scar on the endocardium
to eliminate the source of the dysrhythmias. Endocardium resection involves peeling away a specified
area of the endocardium. Electrical ablation involves using shocks to eliminate the area causing the
dysrhythmias. Radio frequency ablation uses



A patient calls his cardiologist's office and talks to the nurse. He is concerned because he feels he is
being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because
the nurse knows that the most frequent complication of ICD therapy is what?



Infection

Failure to capture

Premature battery depletion

Oversensing of dysrhythmias - correct answerInfection

Failure to capture

Premature battery depletion

Oversensing of dysrhythmias***



Feedback: Inappropriate delivery of ICD therapy, usually due to oversensing of atrial and sinus
tachycardias with a rapid ventricular rate response, is the most frequent complication of ICD. Infections,
failure to capture, and premature battery failure are less common.

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