Nokea
The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?
- A. Apply the paddles directly to the patients skin.
- B. Use a conducting medium between the paddles and the skin.
- C. Always use a petroleum-based gel between the paddles and the skin.
- D. Any available liquid can be used between the paddles and the skin.
Correct Answer: B
Rationale: Use multifunction conductor pads or paddles with a conducting medium between the paddles and the skin (the conducting medium is available as a sheet, gel, or paste). Do not use gels or pastes with poor electrical conductivity.
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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.
The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?
- A. Place gel pads over the apex and posterior chest for better conduction.
- B. Ensure no one is touching the patient at the time shock is delivered.
- C. Continue to ventilate the patient via endotracheal tube during the procedure.
- D. Allow at least 3 minutes between shocks.
Correct Answer: B
Rationale: In external defibrillation, both paddles may be placed on the front of the chest, which is the standard paddle placement. Whether using pads or paddles, the nurse must observe two safety measures. First, maintain good contact between the pads or paddles and the patients skin to prevent leaking. Second, ensure that no one is in contact with the patient or with anything that is touching the patient when the defibrillator is discharged, to minimize the chance that electrical current will be conducted to anyone other than the patient. Ventilation should be stopped during defibrillation.
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.
A patient is brought to the ED and determined to be experiencing symptomatic sinus bradycardia. The nurse caring for this patient is aware the medication of choice for treatment of this dysrhythmia is the administration of atropine. What guidelines will the nurse follow when administering atropine?
- A. Administer atropine 0.5 mg as an IV bolus every 3 to 5 minutes to a maximum of 3.0 mg.
- B. Administer atropine as a continuous infusion until symptoms resolve.
- C. Administer atropine as a continuous infusion to a maximum of 30 mg in 24 hours.
- D. Administer atropine 1.0 mg sublingually.
Correct Answer: A
Rationale: Atropine 0.5 mg given rapidly as an intravenous (IV) bolus every 3 to 5 minutes to a maximum total dose of 3.0 mg is the medication of choice in treating symptomatic sinus bradycardia. By this guideline, the other listed options are inappropriate.
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.