Nokea
The nurse is caring for a client who has premature ventricular contractions. What sign or symptom is observed in this client?
- A. Fluttering
- B. Nausea
- C. Hypotension
- D. Fever
Correct Answer: A
Rationale: Premature ventricular contractions usually cause a flip-flop sensation in the chest, sometimes described as 'fluttering.' Associated signs and symptoms include pallor, nervousness, sweating, and faintness. Symptoms of premature ventricular contractions are not nausea, hypotension, and fever.
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Which of the following does the nurse recognize as the therapeutic goal of radiofrequency catheter ablation for a client with cardiac arrhythmias?
- A. Reperfusion of ischemic heart tissue
- B. Dilation of arterial blood vessels
- C. Destruction of errant tissue
- D. Stimulation of the impulse center
Correct Answer: C
Rationale: The therapeutic goal of radiofrequency catheter ablation is to destroy errant tissue, in hopes of allowing impulse conduction to travel over appropriate pathways. The goal does not include dilation of blood vessels or reperfusion of heart tissue. There is no stimulation of the heart.
Elective cardioversion is similar to defibrillation except that the electrical stimulation waits to discharge until an R wave appears. What does this prevent?
- A. Disrupting the heart during the critical period of atrial repolarization
- B. Disrupting the heart during the critical period of ventricular repolarization
- C. Disrupting the heart during the critical period of ventricular depolarization
- D. Disrupting the heart during the critical period of atrial depolarization
Correct Answer: B
Rationale: It is similar to defibrillation. One difference is that the machine that delivers the electrical stimulation waits to discharge until it senses the appearance of an R wave. By doing so, the machine prevents disrupting the heart during the critical period of ventricular repolarization.
Which of the following medications does the nurse anticipate administering to a client preparing for cardioversion?
- A. Atropine
- B. Digoxin
- C. Enalapril
- D. Diazepam
Correct Answer: D
Rationale: Prior to cardioversion, cardiac medications are held, and the client is sedated with a medication such as diazepam.
The nurse is caring for a client with an arrhythmia. While assessing the data in the history of the chart, the nurse anticipates the cause of the arrhythmia to be which of the following?
- A. Peripheral vascular disease
- B. Ischemic heart disease
- C. Aortic stenosis
- D. Atherosclerotic heart disease
Correct Answer: B
Rationale: The nurse realizes that the most common cause of arrhythmias is ischemic heart disease. When the heart does not obtain sufficient blood to meet demands, the heart works harder to circulate body fluids and becomes inefficient in the process. Problems with the peripheral vessels, narrowing of the aorta and plaque build-up in the vessels may be a component of the disease process but not the best answer.
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.