nurs 618 saunders med surg cardiovascular revised 2021
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NURS 618
Saunders Med
Surg
Cardiovascular
Revised 2021
, NURS 618 Saunders Med Surg Cardiovascular
Revised
Saunders Med Surg Cardiovascular
1. A client admitted to the hospital with chest pain and a history of type 2 diabetes mellitus
is scheduled for cardiac catheterization. Which medication would need to be withheld for
24 hours before the procedure and for 48 hours after the procedure?
• Glipizide
• Metformin
• Repaglinide
• Regular insulin
Answer:
2. Metformin
Rationale:
Metformin needs to be withheld 24 hours before and for 48 hours after cardiac catheterization
because of the injection of contrast medium during the procedure. If the contrast medium
affects kidney function, with metformin in the system the client would be at increased risk for
,lactic acidosis. The medications in the remaining options do not need to be withheld 24 hours
before and 48 hours after cardiac catheterization.
3. The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS
complexes are regular. The PR interval is 0.16 seconds, and QRS complexes measure 0.06
seconds. The overall heart rate is 64 beats/minute. Which action should the nurse take?
1. Check vital signs.
2. Check laboratory test results.
3. Notify the health care provider.
4. Continue to monitor for any rhythm change.
Answer:
4. Continue to monitor for any rhythm change.
Rationale:
Normal sinus rhythm is defined as a regular rhythm, with an overall rate of 60 to 100
beats/minute. The PR and QRS measurements are normal, measuring between 0.12 and
0.20 seconds and 0.04 and 0.10 seconds, respectively. There are no irregularities in this
rhythm currently, so there is no immediate need to check vital signs or laboratory results,
or to notify the health care provider. Therefore, the nurse would continue to monitor the
client for any rhythm change.
, 4. A client is wearing a continuous cardiac monitor, which begins to sound its alarm. The
nurse sees no electrocardiographic complexes on the screen. Which is the priority
nursing action?
• Call a code.
• Call the health care provider.
• Check the client's status and lead placement.
• Press the recorder button on the electrocardiogram console.
Answer:
3. Check the client's status and lead placement.
Rationale:
Sudden loss of electrocardiographic complexes indicates ventricular asystole or possibly
electrode displacement. Accurate assessment of the client and equipment is necessary to
determine the cause and identify the appropriate intervention. The remaining options are
secondary to client assessment.
7. A client's electrocardiogram strip shows atrial and ventricular rates of 110
beats/minute. The PR interval is 0.14 seconds, the QRS complex measures 0.08 seconds,
and the PP and RR intervals are regular. How should the nurse correctly interpret this
rhythm?
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