Nokea
A nurse assists with the cardioversion of a client experiencing acute atrial fibrillation. Which action should the nurse take prior to the initiation of cardioversion?
- A. Administer a sedative to reduce anxiety
- B. Turn off oxygen therapy
- C. Ensure a tongue blade is available
- D. Position the client on their side
Correct Answer: B
Rationale: For safety during cardioversion, the nurse should turn off any oxygen therapy to prevent fire. The other interventions are not appropriate for a cardioversion. The client should be placed in a supine position.
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A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this clients medication administration record to prevent a common complication of this condition.
- A. Sotalol (Betapace)
- B. Warfarin (Coumadin)
- C. Atropine (Sal-Tropine)
- D. Lidocaine (Xylocaine)
Correct Answer: B
Rationale: Atrial fibrillation puts clients at risk for developing emboli. Clients at risk for emboli are treated with anticoagulants, such as heparin, enoxaparin, or warfarin. Sotalol, atropine, and lidocaine are not appropriate for this complication.
A nurse assesses a client with tachycardia. Which clinical manifestation requires immediate intervention by the nurse?
- A. Mid-sternal chest pain
- B. Increased urine output
- C. Mild orthostatic hypotension
- D. P wave touching the T wave
Correct Answer: A
Rationale: Chest pain, possibly angina, indicates that tachycardia may be increasing the client's myocardial workload and oxygen demand to such an extent that normal oxygen delivery cannot keep pace. This results in myocardial hypoxia and pain. Increased urinary output and mild orthostatic hypotension are not life-threatening conditions and therefore do not require immediate intervention. The P wave touching the T wave indicates tachycardia and should be assessed to determine the underlying rhythm and cause, but this is not as critical as chest pain, which indicates cardiac cell death.
A nurse is teaching a client with premature ectopic beats. Which education should the nurse include in this clients teaching? (Select all that apply.)
- A. Smoking cessation
- B. Stress relaxation and management
- C. Avoiding vagal stimulation
- D. Adverse effects of medications
- E. Foods high in potassium
Correct Answer: A,B,D
Rationale: A client who has premature beats or ectopic rhythms should be taught to stop smoking, manage stress, take medications as prescribed, and report adverse effects of medications. Clients with premature beats are not at risk for vasovagal attacks or potassium imbalances.
After assessing a client who is receiving an amiodarone intravenous infusion for unstable ventricular tachycardia, the nurse documents the findings and compares these with the previous assessment findings: [Vital signs data]. Based on the assessments, which action should the nurse take?
- A. Stop the infusion and flush the IV
- B. Slow the amiodarone infusion rate
- C. Administer IV normal saline
- D. Ask the client to cough and deep breathe
Correct Answer: B
Rationale: IV administration of amiodarone may cause bradycardia and atrioventricular (AV) block. The correct action for the nurse to take at this time is to slow the infusion, because the client is asymptomatic and no evidence reveals AV block that might require pacing. Abruptly stopping the medication could allow fatal dysrhythmias to occur.
A nurse assesses a clients electrocardiogram (ECG) and observes the reading shown below: How should the nurse document this clients ECG strip?
- A. Ventricular rhythm
- B. Ventricular fibrillation
- C. Sinus rhythm with premature atrial contractions (PACs)
- D. Sinus rhythm with premature ventricular contractions (PVCs)
Correct Answer: D
Rationale: Sinus rhythm with PVCs has an underlying regular sinus rhythm with ventricular depolarization that sometimes precedes atrial depolarization. Ventricular dysrhythmias and ventricular fibrillation would not have sinus beats present. Premature atrial contractions are atrial contractions initiated from another region of the atria before the sinus node initiates atrial depolarization.