PN2 WEEK 6 EXAM 2 Study guide

PN2 WEEK 6 EXAM 2 Study guide PN2 WEEK 6 EXAM 2 Study guide Study guide for Exam #2 Week 6 Chapters 33, 34, 35,36,39,40 1. Effects of beta-blockers on heart and heart rate -Beta Blocker will decrease Heart Rate and Blood pressure. -Assess heart rate (HR) and blood pressure (BP) before administration because beta blockers cause a decrease in HR and cardiac output and suppress renin activity. • Do not administer if HR is 50-60 beats/min. • Hold for systolic 90-100 mm HG and contact the health care provider. • Monitor for orthostatic hypotension because this is a common adverse effect that can contribute to falls and confusion, especially in older adults. - Use with caution in patients with diabetes because glucose production may be affected. - Teach the patient that these agents can cause fatigue, depression, and sexual dysfunction. These adverse effects should be reported to the primary health care provider. 2. Complications of atrial fibrillation -Atrial fibrillation occurs commonly in clients with cardiac disease and is a common reoccurrence after coronary artery bypass graft surgery. -Clients are at risk for embolitic stroke. Evidence of embolitic events includes changes I mentation, speech, sensory function, and motor function. -Clients with A-fib often have a rapid ventricular response as a result. - Clients with a-fib are at risk for decreased cardiac output and fatigue when completing activities of daily living. -Nursing Intervention: schedule periods of rest and exercise during the day. -for patients with acute a-fib who have a cardioversion, the nurse should turn off any oxygen therapy to prevent fire. 3. Complications from wide QRS and bradycardia combined, what does it mean? -An HR of 40 beats/min or less with widened QRS complexes could have hemodynamic consequences. The client is at risk for inadequate cerebral perfusion. The nurse should assess for level of consciousness, lightheadedness, confusion, syncope and seizure activity. 4. What does pacer spikes without QRS complex imply and what complication can it cause?