Nokea
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.
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The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurses assessment?
- A. Assessing the patients activity level
- B. Facilitating transthoracic echocardiography
- C. Vigilant monitoring of the patients ECG
- D. Close monitoring of the patients peripheral perfusion
Correct Answer: C
Rationale: After a permanent electronic device (pacemaker or ICD) is inserted, the patients heart rate and rhythm are monitored by ECG. This is a priority over peripheral circulation and activity. Echocardiography is not indicated.
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.
During a patients care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery?
- A. Angina pectoris not responsive to other treatments
- B. Decreased activity tolerance related to decreased cardiac output
- C. Atrial and ventricular tachycardias not responsive to other treatments
- D. Ventricular fibrillation not responsive to other treatments
Correct Answer: C
Rationale: Cardiac conduction surgery is considered in patients who do not respond to medications and antitachycardia pacing. Angina, reduced activity tolerance, and ventricular fibrillation are not criteria.
A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a patients cardiac function in what way?
- A. Exacerbating an existing dysrhythmia
- B. Initiating a new dysrhythmia
- C. Resolving ventricular tachycardia
- D. Increasing the heart rate
Correct Answer: D
Rationale: Stimulation of the sympathetic system increases heart rate. This phenomenon is known as positive chronotropy. It does not influence dysrhythmias.
A patient is scheduled for catheter ablation therapy. When describing this procedure to the patients family, the nurse should address what aspect of the treatment?
- A. Resetting of the hearts contractility
- B. Destruction of specific cardiac cells
- C. Correction of structural cardiac abnormalities
- D. Clearance of partially occluded coronary arteries
Correct Answer: B
Rationale: Catheter ablation destroys specific cells that are the cause or central conduction route of a tachydysrhythmia. It does not reset the hearts contractility and it does not address structural or vascular abnormalities.