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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.
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The client has just been diagnosed with a arrhythmia. The client asks the nurse to explain normal sinus rhythm. What would the nurse explain is the characteristic of normal sinus rhythm?
- A. Heart rate between 60 and 150 beats/minute.
- B. Impulse travels to the atrioventricular (AV) node in 0.15 to 0.5 second.
- C. The ventricles depolarize in 0.5 second or less.
- D. The sinoatrial (SA) node initiates the impulse.
Correct Answer: D
Rationale: The characteristics of normal sinus rhythm are heart rate between 60 and 100 beats/minute, the SA node initiates the impulse, the impulse travels to the AV node in 0.12 to 0.2 second, the ventricles depolarize in 0.12 seconds or less, and each impulse occurs regularly.
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.
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.
The staff educator is teaching a class in arrhythmias. What statement is correct for defibrillation?
- A. It is a scheduled procedure 1 to 10 days in advance.
- B. The client is sedated before the procedure.
- C. It is used to eliminate ventricular arrhythmias.
- D. It uses less electrical energy than cardioversion.
Correct Answer: C
Rationale: The only treatment for a life-threatening ventricular arrhythmia is immediate defibrillation, which has the exact same effect as cardioversion, except that defibrillation is used when there is no functional ventricular contraction. It is an emergency procedure performed during resuscitation. The client is not sedated but is unresponsive. Defibrillation uses more electrical energy (200 to 360 joules) than cardioversion.
The nursing student is taking a pre-nursing pharmacology class. Today, the nursing student is learning about antiarrhythmic drugs. What drug is a potassium channel blocker?
- A. Amiodarone
- B. Lidocaine
- C. Flecainide
- D. Isoproterenol
Correct Answer: A
Rationale: Potassium channel blockers include amiodarone and bretylium tosylate. Lidocaine and flecainide are sodium channel blockers. Isoproterenol is a beta-blocker.