Nokea
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.
You may also like to solve these questions
A nurse supervises an unlicensed assistive personnel (UAP) applying electrocardiographic monitoring. Which statement should the nurse provide to the UAP related to this procedure?
- A. Clean the skin and clip hairs if needed
- B. Add gel to the chest prior to applying them
- C. Place the electrodes on the posterior chest
- D. Turn off oxygen prior to monitoring the client
Correct Answer: A
Rationale: To ensure the best signal transmission, the skin should be clean and hairs clipped. Electrodes should be placed on the anterior chest, and no additional gel is needed. Oxygen has no impact on electrocardiographic monitoring.
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 client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?
- A. Sinus tachycardia
- B. Speech alterations
- C. Fatigue
- D. Dyspnea with activity
Correct Answer: B
Rationale: Clients with atrial fibrillation are at risk for embolic stroke. Evidence of embolic events includes changes in speech, sensory function, and motor function. Clients with atrial fibrillation often have a rapid ventricular response as a result. Fatigue is a nonspecific complaint. Clients with atrial fibrillation often have dyspnea as a result of the decreased cardiac output caused by the rhythm disturbance.
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.
A telemetry nurse assesses a client with third-degree heart block who has wide QRS complexes and a heart rate of 35 beats/min on the cardiac monitor. Which assessment should the nurse complete next?
- A. Pulmonary auscultation
- B. Pulse strength and amplitude
- C. Level of consciousness
- D. Mobility and gait stability
Correct Answer: C
Rationale: A heart rate 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, dyspnea, and seizure activity. Although the other assessments should be completed, the client's level of consciousness is the priority.