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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?
- A. Defibrillation
- B. ECG monitoring
- C. Implantation of a cardioverter defibrillator
- D. Angioplasty
Correct Answer: A
Rationale: 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.
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The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patients care, the nurse should recognize what goal of this intervention?
- A. Resynchronization
- B. Defibrillation
- C. Angioplasty
- D. Ablation
Correct Answer: A
Rationale: Biventricular (both ventricles) pacing, also called resynchronization therapy, may be used to treat advanced heart failure that does not respond to medication. This type of pacing therapy is not called defibrillation, angioplasty, or ablation therapy.
The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output?
- A. Increased blood pressure
- B. Bounding peripheral pulses
- C. Changes in level of consciousness
- D. Skin flushing
Correct Answer: C
Rationale: The nurse conducts a physical assessment to confirm the data obtained from the history and to observe for signs of diminished cardiac output (CO) during the dysrhythmic event, especially changes in level of consciousness. Blood pressure tends to decrease with lowered CO and bounding peripheral pulses are inconsistent with this problem. Pallor, not skin flushing, is expected.
A group of nurses are participating in orientation to a telemetry unit. What should the staff educator tell this class about ST segments?
- A. They are the part of an ECG that reflects systole.
- B. They are the part of an ECG used to calculate ventricular rate and rhythm.
- C. They are the part of an ECG that reflects the time from ventricular depolarization through repolarization.
- D. They are the part of an ECG that represents early ventricular repolarization.
Correct Answer: D
Rationale: 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.
The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?
- A. Apply the paddles directly to the patients skin.
- B. Use a conducting medium between the paddles and the skin.
- C. Always use a petroleum-based gel between the paddles and the skin.
- D. Any available liquid can be used between the paddles and the skin.
Correct Answer: B
Rationale: Use multifunction conductor pads or paddles with a conducting medium between the paddles and the skin (the conducting medium is available as a sheet, gel, or paste). Do not use gels or pastes with poor electrical conductivity.
A patient calls his cardiologists 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?
- A. Infection
- B. Failure to capture
- C. Premature battery depletion
- D. Oversensing of dysrhythmias
Correct Answer: D
Rationale: 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.