CH 26 PREPU MGMNT OG PTS W
DYSRHYTHMIAS AND CONDUCTION
PROBLEM EXAM QUESTIONS AND WELL
EXPLAINED ANSWERS.
The best representation of a nursing concern related to a cardiac
arrhythmia is the inability of the heart to fill the chambers and eject blow
flow efficiently. Lack of an efficient method to circulate blood and bodily
fluids produces a variety of complications such as tissue ischemia,
pulmonary edema, hypotension, decreased urine output, and impaired level
of consciousness. The other options can occur with dysrhythmias, but the
cause stemming from the altered pattern is the best answer.
The nurse is working on a monitored unit assessing the cardiac monitor
rhythms. Which waveform pattern needs attention first?
Supraventricular tachycardia Atrial fibrillation Sustained asystole
Ventricular fibrillation - CorreCt Answers -D
Ventricular fibrillation is called the rhythm of a dying heart. It is the
rhythm that needs attention first because there is no cardiac output, and it
is an indication for CPR and immediate defibrillation. Sustained asystole
either is from death, or the client is off of the cardiac monitor.
Supraventricular tachycardia and atrial fibrillation is monitored and
reported to the physician but is not addressed first.
A nurse provides evening care for a client wearing a continuous telemetry
monitor. While the nurse is giving the client a back rub, the client 's
,monitor alarm sounds and the nurse notes a flat line on the bedside
monitor system. What is the nurse's first response?
Call a code and obtain the crash cart. Administer a pericardial thump. Call
for assistance and begin CPR. Assess the client and monitor leads. - CorreCt
Answers -D
The nurse should assess the client and monitor leads first. It is important
that the nurse "treat the client, not the monitor." Ventricular asystole may
often appear on the monitor when leads are displaced. The other
interventions are not necessary.
The nurse in the intensive care unit (ICU) hears an alarm sound in the
patient's room. Arriving in the room, the patient is unresponsive, without a
pulse, and a flat line on the monitor. What is the first action by the nurse?
Begin cardiopulmonary resuscitation (CPR) Defibrillate with 360 joules
(monophasic defibrillator) Administer epinephrine Administer atropine 0.5
mg - CorreCt Answers -A
Commonly called flatline, ventricular asystole (Fig. 26-19) is characterized
by absent QRS complexes confirmed in two different leads, although P
waves may be apparent for a short duration. There is no heartbeat, no
palpable pulse, and no respiration. Without immediate treatment,
ventricular asystole is fatal. Ventricular asystole is treated the same as PEA,
focusing on high-quality CPR with minimal interruptions and identifying
underlying and contributing factors.
, The nurse is observing the monitor of a patient with a first-degree
atrioventricular (AV) block. What is the nurse aware characterizes this
block?
A variable heart rate, usually fewer than 60 bpm
An irregular rhythm
P waves hidden with the QRS complex
Delayed conduction, producing a prolonged PR interval - CorreCt Answers
-D
First-degree AV block occurs when all the atrial impulses are conducted
through the AV node into the ventricles at a rate slower than normal. Thus
the PR interval is prolonged (>0.20 seconds).
The nurse is assessing vital signs in a patient with a permanent pacemaker.
What should the nurse document about the pacemaker?
Model number Pacer rate Location of the generator Date and time of
insertion - CorreCt Answers -B
After a permanent pacemaker is inserted, the patient's heart rate and
rhythm are monitored by ECG.
DYSRHYTHMIAS AND CONDUCTION
PROBLEM EXAM QUESTIONS AND WELL
EXPLAINED ANSWERS.
The best representation of a nursing concern related to a cardiac
arrhythmia is the inability of the heart to fill the chambers and eject blow
flow efficiently. Lack of an efficient method to circulate blood and bodily
fluids produces a variety of complications such as tissue ischemia,
pulmonary edema, hypotension, decreased urine output, and impaired level
of consciousness. The other options can occur with dysrhythmias, but the
cause stemming from the altered pattern is the best answer.
The nurse is working on a monitored unit assessing the cardiac monitor
rhythms. Which waveform pattern needs attention first?
Supraventricular tachycardia Atrial fibrillation Sustained asystole
Ventricular fibrillation - CorreCt Answers -D
Ventricular fibrillation is called the rhythm of a dying heart. It is the
rhythm that needs attention first because there is no cardiac output, and it
is an indication for CPR and immediate defibrillation. Sustained asystole
either is from death, or the client is off of the cardiac monitor.
Supraventricular tachycardia and atrial fibrillation is monitored and
reported to the physician but is not addressed first.
A nurse provides evening care for a client wearing a continuous telemetry
monitor. While the nurse is giving the client a back rub, the client 's
,monitor alarm sounds and the nurse notes a flat line on the bedside
monitor system. What is the nurse's first response?
Call a code and obtain the crash cart. Administer a pericardial thump. Call
for assistance and begin CPR. Assess the client and monitor leads. - CorreCt
Answers -D
The nurse should assess the client and monitor leads first. It is important
that the nurse "treat the client, not the monitor." Ventricular asystole may
often appear on the monitor when leads are displaced. The other
interventions are not necessary.
The nurse in the intensive care unit (ICU) hears an alarm sound in the
patient's room. Arriving in the room, the patient is unresponsive, without a
pulse, and a flat line on the monitor. What is the first action by the nurse?
Begin cardiopulmonary resuscitation (CPR) Defibrillate with 360 joules
(monophasic defibrillator) Administer epinephrine Administer atropine 0.5
mg - CorreCt Answers -A
Commonly called flatline, ventricular asystole (Fig. 26-19) is characterized
by absent QRS complexes confirmed in two different leads, although P
waves may be apparent for a short duration. There is no heartbeat, no
palpable pulse, and no respiration. Without immediate treatment,
ventricular asystole is fatal. Ventricular asystole is treated the same as PEA,
focusing on high-quality CPR with minimal interruptions and identifying
underlying and contributing factors.
, The nurse is observing the monitor of a patient with a first-degree
atrioventricular (AV) block. What is the nurse aware characterizes this
block?
A variable heart rate, usually fewer than 60 bpm
An irregular rhythm
P waves hidden with the QRS complex
Delayed conduction, producing a prolonged PR interval - CorreCt Answers
-D
First-degree AV block occurs when all the atrial impulses are conducted
through the AV node into the ventricles at a rate slower than normal. Thus
the PR interval is prolonged (>0.20 seconds).
The nurse is assessing vital signs in a patient with a permanent pacemaker.
What should the nurse document about the pacemaker?
Model number Pacer rate Location of the generator Date and time of
insertion - CorreCt Answers -B
After a permanent pacemaker is inserted, the patient's heart rate and
rhythm are monitored by ECG.
