MED SURG CHP 26 PREP U MANAGEMENT OF PATIENTS WITH
DYSRHYTHMIAS AND CONDUCTION PROBLEMS STUDY
GUIDE WITH COMPLETE SOLUTION!!
A nurse is teaching the client about the causes of fast heart rates. What client
statement indicates the client requires more teaching?
Answers "I will drink coffee with only two of my meals."
The licensed practical nurse is co-assigned with a registered nurse in the care of a
client admitted to the cardiac unit with chest pain. The licensed practical nurse is
assessing the accuracy of the cardiac monitor, which notes a heart rate of 34
beats/minute. The client appears anxious and states not feeling well. The licensed
practical nurse confirms the monitor reading. When consulting with the registered
nurse, which of the following is anticipated?
Answers The registered nurse administering atropine sulfate intravenously
(The licensed practical nurse and registered nurse both identify that client's
bradycardia. Atropine sulfate, a cholinergic blocking agent, is given intravenously
(IV) to increase a dangerously slow heart rate. Lanoxin is not administered when
the pulse rate falls under 60 beats/minute. It is dangerous to wait until the pulse
rate increases without nursing intervention or administering additional medications
until the imminent concern is addressed.)
A nurse completes a shift assessment on a client admitted to the telemetry unit with
a diagnosis of syncope. The client's heart rate is 55 bpm with a blood pressure of
90/66 mm Hg. The client is also experiencing dizziness and shortness of breath.
Which medication will the nurse anticipate administering to the client based on
these clinical findings?
Answers Atropine
, (The client is demonstrating signs and symptoms of symptomatic sinus
bradycardia. Atropine is the medication of choice in treating symptomatic sinus
bradycardia. Lidocaine treats ventricular dysrhythmias. Pronestyl treats and
prevents atrial and ventricular dysrhythmias. Cardizem is a calcium channel
blocker and treats atrial dysrhythmias.)
A client is admitted to the emergency department reporting chest pain and
shortness of breath. The nurse notes an irregular rhythm on the bedside
electrocardiograph monitor. The nurse counts 9 RR intervals on the client's 6-
second rhythm tracing. The nurse correctly identifies the client's heart rate as
Answers 90 bpm.
(An alternative but less accurate method for estimating heart rate, which is usually
used when the rhythm is irregular, is to count the number of RR intervals in 6
seconds and multiply that number by 10. The RR intervals are counted, rather than
QRS complexes, because a computed heart rate based on the latter might be
inaccurately high. The same methods may be used for determining atrial rate, using
the PP interval instead of the RR interval. In this instance, 9 × 10 = 90.)
The client asks the nurse to explain what is meant by a ventricular bigeminy
cardiac rhythm. What is the best response by the nurse?
Answers "The rhythm has a normal beat, then a premature beat pattern."
(Bigeminy is a rhythm in which every other complex is a premature ventricular
contraction (PVC). In trigeminy, every third complex is a PVC. The rhythm is not
regular and the rate should not be 150-250 bpm.)
The nurse witnesses a client experiencing ventricular fibrillation. What is the
nurse's priority action?
Answers defibrillation
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