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A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patients care?
- A. Ablate the area causing the dysrhythmia.
- B. Freeze hypersensitive cells.
- C. Diagnose the dysrhythmia.
- D. Determine the nursing plan of care.
Correct Answer: C
Rationale: A patient may undergo an EP study in which electrodes are placed inside the heart to obtain an intracardiac ECG. This is used not only to diagnose the dysrhythmia but also to determine the most effective treatment plan. However, because an EP study is invasive, it is performed in the hospital and may require that the patient be admitted.
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An ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?
- A. Clean the skin with providone-iodine solution.
- B. Ensure that the area for electrode placement is dry.
- C. Apply tincture of benzoin to the electrode sites and wait for it to become tacky.
- D. Gently abrade the skin by rubbing the electrode sites with dry gauze or cloth.
Correct Answer: D
Rationale: An ECG is obtained by slightly abrading the skin with a clean dry gauze pad and placing electrodes on the body at specific areas. The abrading of skin will enhance signal transmission. Disinfecting the skin is unnecessary and conduction gel is used.
When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?
- A. Core body temperature
- B. Heart rate and rhythm
- C. Blood pressure
- D. Oxygen saturation level
Correct Answer: B
Rationale: For patients with pacemakers, close monitoring of the heart rate and rhythm is a priority, even though each of the other listed vital signs must be assessed.
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.
A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would be the nurses best response?
- A. To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia
- B. To detect and treat bradycardia, which is an excessively slow heart rate
- C. To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently
- D. To shock your heart if you have a heart attack at home
Correct Answer: A
Rationale: The ICD is a device that detects and terminates life-threatening episodes of ventricular tachycardia and ventricular fibrillation. It does not treat atrial fibrillation, MI, or bradycardia.
The nurse is caring for a patient who has had an ECG. The nurse notes that leads I, II, and III differ from one another on the cardiac rhythm strip. How should the nurse best respond?
- A. Recognize that the view of the electrical current changes in relation to the lead placement.
- B. Recognize that the electrophysiological conduction of the heart differs with lead placement.
- C. Inform the technician that the ECG equipment has malfunctioned.
- D. Inform the physician that the patient is experiencing a new onset of dysrhythmia.
Correct Answer: A
Rationale: Each lead offers a different reference point to view the electrical activity of the heart. The lead displays the configuration of electrical activity of the heart. Differences between leads are not necessarily attributable to equipment malfunction or dysrhythmias.