Nokea
The nurse and student nurse are observing a cardioversion procedure. The nurse is correct to tell the student that electrical current will be initiated at which time?
- A. During stimulation of the SA node
- B. During repolarization of the heart
- C. During ventricular depolarization
- D. During the contraction phase
Correct Answer: C
Rationale: The electrical current is initiated at the R wave when ventricular depolarization occurs. The electrical current completely depolarizes the entire myocardium with the goal of restoring the normal pacemaker of the heart.
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The nurse is caring for a client with atrial fibrillation. What procedure would be recommended if drug therapies did not control the arrhythmia?
- A. Defibrillation
- B. Maze procedure
- C. Pacemaker implantation
- D. Elective cardioversion
Correct Answer: D
Rationale: Atrial fibrillation is treated with elective cardioversion or digitalis if the ventricular rate is not too slow. Defibrillation is used for a ventricular problem. Maze procedures are used for clients who are not candidates for cardio diversion; these procedures use scar-forming techniques to eliminate rapid firing of ectopic pacemaker sites, thus restoring the normal conduction pathways in the atria. A Maze procedure might be considered for this client only after determining ineligibility for cardiodiversion. Pacemakers are implanted for bradycardia.
Which diagnostic study best evaluates different medications' ability to restore normal heart rhythm?
- A. Elective electrical cardioversion
- B. Electrocardiogram (ECG)
- C. Electrophysiology study
- D. Echocardiogram
Correct Answer: C
Rationale: An electrophysiology study is a procedure that enables the physician to examine the electrical activity of the heart, produce actual arrhythmias, and determine the best method for care. Cardioversion uses synchronized electricity to change the rhythm pattern. Electrocardiogram and echocardiograms provide diagnostic information.
The nurse is caring for clients on a telemetry unit. Which nursing consideration best represents concerns of altered rhythmic patterns of the heart?
- A. Altered patterns frequently turn into life-threatening arrhythmias.
- B. Altered patterns frequently produce neurological deficits.
- C. Altered patterns frequently cause a variety of home safety issues.
- D. Altered patterns frequently affect the heart's ability to pump blood effectively.
Correct Answer: D
Rationale: The best representation of a nursing concern related to a cardiac arrhythmia is the inability of the heart to fill the chambers and eject blood flow efficiently. Lack of an efficient method to circulate blood and bodily fluids produces a variety of complications such as tissue ischemia, pulmonary edema, hypotension, decreased urine output, and impaired level of consciousness. The other options can occur with arrhythmias, but the cause stemming from the altered pattern is the best answer.
For which client does the nurse anticipate cardioversion as a possible medical treatment?
- A. A new myocardial infarction client
- B. A client with poor kidney perfusion
- C. A client with third-degree heart block
- D. A client with atrial arrhythmias
Correct Answer: D
Rationale: The nurse is correct to identify a client with atrial arrhythmias as a candidate for cardioversion. The goal of cardioversion is to restore the normal pacemaker of the heart, as well as normal conduction. A client with a myocardial infarction has tissue damage. The client with poor perfusion has circulation problems. The client with heart block has an impairment in the conduction system and may require a pacemaker.
The nurse enters the client's room and finds the client pulseless and unresponsive. What would be the treatment of choice for this client?
- A. IV lidocaine
- B. Chemical cardioversion
- C. Immediate defibrillation
- D. Electric cardioversion
Correct Answer: C
Rationale: Defibrillation is used during pulseless ventricular tachycardia and ventricular fibrillation.