Cardiac Dysrhythmias Nursing Interventions Stokke
A cardiac dysrhythmia is an abnormal heartbeat: the rhythm may be irregular in it’s pacing or the heart rate may be low or high. Some dysrhythmias are potentially life threatening while other dysrhythmias are normal. Take the cardiac dysrhythmias nursing interventions on stroke quiz and get to refresh your memory before the nursing exam.
- 1.
If your patient has Sinus tachycardia, which of the following is not a concerning sign/symptom?
- A.
Diaphoresis
- B.
Chest pain
- C.
Unaware it is happening
- D.
None of the above
Correct Answer
C. Unaware it is happeningExplanation
Sinus tachycardia is a condition characterized by a rapid heart rate that originates from the sinus node in the heart. It can be caused by various factors such as exercise, stress, or certain medications. Diaphoresis, which refers to excessive sweating, and chest pain are commonly associated symptoms of sinus tachycardia. However, being unaware that the tachycardia is happening is not a concerning sign/symptom because it is possible for individuals to experience sinus tachycardia without being consciously aware of it. Therefore, the correct answer is "Unaware it is happening."Rate this question:
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- 2.
The goal of caring for a patient with sinus tachycardia (HR 120) is to _________________ and nursing care tasks that can do that are ________________________.
- A.
Slow the heart rate down; call the doctor right away, there is nothing a nurse can do to help the patient.
- B.
Relax the patient; encourage him/her to lay down, give medications to promote sleep
- C.
Slow the heart rate; encourage the patient to rest, give ordered medications for heart rate and pain, and provide O2 if indicated
Correct Answer
C. Slow the heart rate; encourage the patient to rest, give ordered medications for heart rate and pain, and provide O2 if indicatedExplanation
The goal of caring for a patient with sinus tachycardia (HR 120) is to slow the heart rate down. Nursing care tasks that can help achieve this goal include encouraging the patient to rest, giving ordered medications for heart rate and pain, and providing oxygen if indicated.Rate this question:
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- 3.
Which scenario is concerning even if a patient seems to be tolerating it well?
- A.
A patient who just walked up 4 flights of stairs and has a HR of 190
- B.
A sleeping patient with a HR of 55
- C.
A sleeping patient with a HR of 190
Correct Answer
C. A sleeping patient with a HR of 190Explanation
A sleeping patient with a HR of 190 is concerning because a heart rate of 190 during sleep is abnormally high and could indicate a potential cardiac issue or a disturbance in the heart's electrical system. This could be a sign of tachycardia, which is an abnormal rapid heart rate. It is important to investigate and monitor the patient further to determine the cause of the elevated heart rate and ensure their safety.Rate this question:
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- 4.
You are caring for a patient who has had a HR of 70 all day, then after you give him his afternoon dose of Beta blocker, it suddenly falls to 50 though he is not asleep, he seems to be comfortable; which of the following would be indicated?
- A.
No changes because the patient is lying in bed. He is probably just relaxing.
- B.
Go in and take his pulse by hand to be sure it is not just equipment/positioning issue, then call the doctor with the results and ask for atropine to raise the heart rate
- C.
Go in and take his pulse by hand, then monitor the rhythm, and check his vitals every 15 minutes for the next hour, then call the doctor and request a lower dose of the Beta blocker. Encourage the patient to stay in bed.
Correct Answer
C. Go in and take his pulse by hand, then monitor the rhythm, and check his vitals every 15 minutes for the next hour, then call the doctor and request a lower dose of the Beta blocker. Encourage the patient to stay in bed.Explanation
The correct answer is to go in and take his pulse by hand, then monitor the rhythm, and check his vitals every 15 minutes for the next hour, then call the doctor and request a lower dose of the Beta blocker. Encourage the patient to stay in bed. This is the most appropriate action because the sudden decrease in heart rate after administering the beta blocker could indicate a potential adverse reaction or side effect. By monitoring the patient's rhythm and vital signs, as well as contacting the doctor for further guidance, the healthcare provider can ensure the patient's safety and well-being. Encouraging the patient to stay in bed helps to minimize any potential complications.Rate this question:
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- 5.
Most patients tolerate PACs with no necessary interventions.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement suggests that most patients are able to tolerate PACs (premature atrial contractions) without needing any interventions. This means that PACs are not usually a cause for concern and do not require any medical treatment or intervention. Therefore, the correct answer is True.Rate this question:
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- 6.
You are caring for a patient with PACs after a shoulder surgery in the hospital. When documenting the heart rate and rhythm, it is important to:
- A.
Print off a strip and put it in the chart with a note for the doctor.
- B.
Note the underlying rhythm
- C.
Note whether the PACs are frequent, rare, or occasional.
- D.
All of the above
Correct Answer
D. All of the aboveExplanation
When caring for a patient with premature atrial contractions (PACs) after shoulder surgery, it is important to document the heart rate and rhythm accurately. Printing off a strip and putting it in the chart with a note for the doctor ensures that there is a visual representation of the rhythm for future reference. Noting the underlying rhythm helps in understanding the pattern and potential causes of the PACs. Additionally, documenting whether the PACs are frequent, rare, or occasional provides important information about the severity and frequency of the arrhythmia. Therefore, all of the above options are important when documenting the heart rate and rhythm in this scenario.Rate this question:
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- 7.
Atrial fibrillation with a HR > 100 is considered an uncontrolled A-fib with rapid ventricular rhythm (RVR).
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
Atrial fibrillation is a condition characterized by irregular and rapid heart rate. When the heart rate exceeds 100 beats per minute, it is considered uncontrolled and is referred to as atrial fibrillation with rapid ventricular rhythm (RVR). This means that the atria of the heart are not contracting properly, leading to an irregular and fast heartbeat. Therefore, the statement that atrial fibrillation with a heart rate greater than 100 is considered uncontrolled with RVR is true.Rate this question:
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- 8.
In A Fib, the _________ is/are in control because the __________ is not firing.
- A.
SA node; AV node
- B.
Ventricles; SA node
- C.
AV node; SA node
Correct Answer
C. AV node; SA nodeExplanation
In atrial fibrillation (A Fib), the normal electrical conduction pathway of the heart is disrupted. The SA node, which is responsible for initiating the electrical signals that regulate the heart's rhythm, is not firing properly. As a result, the AV node takes over control of the heart's electrical signals and determines the rate at which the ventricles contract. Therefore, in A Fib, the AV node is in control because the SA node is not firing.Rate this question:
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- 9.
An appropriate nursing response to A Fib would be to:
- A.
Nothing unless the patient is not tolerating it; if not tolerating, go with option B or C.
- B.
Chemical cardioversion with digoxen, Ca channel blockers, or diltiazem
- C.
Electrocardioversion with a defibrillator set on synchronise
- D.
Both b and c
- E.
All of the above
Correct Answer
D. Both b and cExplanation
The appropriate nursing response to A Fib would be to consider chemical cardioversion with digoxen, Ca channel blockers, or diltiazem if the patient is not tolerating it. Additionally, electrocardioversion with a defibrillator set on synchronize can also be considered. Therefore, the correct answer is both b and c, as both options are appropriate nursing responses to A Fib depending on the patient's tolerance.Rate this question:
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- 10.
Patients with A Fib are often
- A.
Given long-term treatment with medications like digoxen, Beta blockers, and Cumadin
- B.
Sent straight to long-term care because they are too much at risk to be at home
- C.
Cured after one defibrillation and sent home with no meds
Correct Answer
A. Given long-term treatment with medications like digoxen, Beta blockers, and CumadinExplanation
Patients with A Fib are often given long-term treatment with medications like digoxen, Beta blockers, and Coumadin. This is because A Fib is a chronic condition that requires ongoing management to control the irregular heart rhythm and prevent complications such as blood clots. Medications like digoxin help to regulate the heart rate, while beta blockers and Coumadin are used to prevent blood clots. Long-term treatment is necessary to maintain the stability of the heart rhythm and reduce the risk of stroke or other cardiovascular events.Rate this question:
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- 11.
The treatment for Atrial Flutter is the same as for A Fib except the physician can do a carotid massage to slow the HR down.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because both Atrial Flutter and A Fib are abnormal heart rhythms that can be treated similarly. The main difference is that in Atrial Flutter, the heart rate is usually faster and more regular compared to A Fib. Carotid massage, a technique that involves applying pressure to the carotid artery in the neck, can help slow down the heart rate in certain cases of Atrial Flutter. However, it is important to note that carotid massage should only be done by a physician and under specific circumstances.Rate this question:
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- 12.
Patients with a 1st degree AV block usually _____________, but sometimes _______________.
- A.
Tolerate it; need a pacemaker
- B.
Need a pacemaker; tolerate it
- C.
Respond well to meds; need electrocardioconversion
Correct Answer
A. Tolerate it; need a pacemakerExplanation
Patients with a 1st degree AV block usually tolerate it, but sometimes need a pacemaker. This means that most patients with a 1st degree AV block are able to manage the condition without any major symptoms or complications. However, in some cases, the block may progress or cause symptoms that require the use of a pacemaker to regulate the heart's electrical activity and ensure proper functioning.Rate this question:
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- 13.
When caring for a patient with atrial flutter, it is important to take his/her pulse for _____________ to get an accurate HR.
- A.
30 seconds and multiply it by two
- B.
1 minute
- C.
2 minutes and divide it by two
Correct Answer
B. 1 minuteExplanation
When caring for a patient with atrial flutter, it is important to take his/her pulse for 1 minute to get an accurate heart rate. This is because atrial flutter is a type of abnormal heart rhythm where the atria beat very fast and regularly, but the ventricles beat at a slower rate. By taking the pulse for a full minute, it allows for a more accurate measurement of the heart rate, as it takes into account the slower ventricular rate.Rate this question:
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- 14.
With a patient with an AV block, it is important to keep in mind that ______________________________.
- A.
Potassium channel blockers may prolong the PR interval and you may have to lower the dose.
- B.
Digoxen and Calcium channel blockers may prolong the PR interval and you may have to lower the dose.
- C.
Potassium and Calcium channel blockers may shorten the PR interval and you may have to increase the dose.
Correct Answer
B. Digoxen and Calcium channel blockers may prolong the PR interval and you may have to lower the dose.Explanation
With a patient with an AV block, it is important to keep in mind that Digoxen and Calcium channel blockers may prolong the PR interval and you may have to lower the dose. This is because AV block is a condition where the electrical signals between the atria and ventricles of the heart are delayed or blocked. Digoxen and Calcium channel blockers can further slow down the conduction of these signals, leading to a prolonged PR interval. To prevent excessive slowing of the heart rate, it may be necessary to decrease the dose of these medications.Rate this question:
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- 15.
Most patients with a 2nd degree AV block __________, but some ___________.
- A.
Tolerate it; need a pacemaker
- B.
Need a pacemaker; tolerate it
- C.
Respond well to meds; need electrocardioconversion
Correct Answer
A. Tolerate it; need a pacemakerExplanation
Most patients with a 2nd degree AV block are able to tolerate it, meaning they can live with the condition without experiencing significant symptoms or complications. However, there are some patients who may need a pacemaker, which is a small device that helps regulate the heart's electrical activity. This is because their AV block may be more severe or causing symptoms that require intervention to ensure proper heart function.Rate this question:
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- 16.
A patient who is not tolerating a 3d degree AV block will show which of the following signs and symptoms?
- A.
Decreased BP, SOB, decreased O2, decreased HR, mentation changes
- B.
Diaphoresis, angina, SOB, "crackles" in lungs, dizziness
- C.
Orthostatic hypotension, increased HR, increased temp, and SOB
Correct Answer
A. Decreased BP, SOB, decreased O2, decreased HR, mentation changesExplanation
A patient who is not tolerating a 3rd degree AV block will show signs and symptoms such as decreased blood pressure (BP), shortness of breath (SOB), decreased oxygen (O2) levels, decreased heart rate (HR), and changes in mentation. This is because a 3rd degree AV block disrupts the electrical signals between the atria and ventricles, leading to a lack of coordination in heart contractions. As a result, the heart is unable to pump blood effectively, leading to decreased BP. The lack of oxygenated blood reaching the body's tissues can cause SOB and decreased O2 levels. The decreased HR is a result of the blockage in the electrical conduction system. Changes in mentation may occur due to decreased cerebral perfusion caused by the decreased cardiac output.Rate this question:
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- 17.
If a patient with a 3d degree AV block is hemodynamically unstable, what will be the treatment?
- A.
Pacemaker
- B.
Cardioconversion
- C.
All of the above
Correct Answer
A. PacemakerExplanation
In a patient with a 3rd degree AV block who is hemodynamically unstable, the most appropriate treatment would be a pacemaker. A 3rd degree AV block is a complete blockage of the electrical signals between the atria and ventricles, resulting in a complete dissociation of atrial and ventricular contractions. This can lead to a dangerously slow heart rate and inadequate cardiac output. A pacemaker is a device that helps regulate the heart rate by providing electrical stimulation to the heart when necessary, ensuring proper coordination between the atria and ventricles and maintaining a stable heart rate. Cardioconversion, on the other hand, is a treatment option for certain arrhythmias but is not specifically indicated for 3rd degree AV block. Therefore, the correct answer is pacemaker.Rate this question:
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- 18.
Hemodynamically unstable means decreased CO, decreased BP, and decreased pulse.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
The statement is true because hemodynamic instability refers to a condition where there is a decrease in cardiac output (CO), blood pressure (BP), and pulse. These parameters are essential for maintaining adequate blood flow and oxygen delivery to the body's organs and tissues. When they are decreased, it indicates that the body is unable to maintain proper circulation, which can be a critical and life-threatening situation. Therefore, the given statement accurately describes the characteristics of hemodynamic instability.Rate this question:
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- 19.
If your patient has a short burst of Ventricular Tachycardia, it is important to _______________________
- A.
Put a strip in his chart and make a note for the doctor to look at it.
- B.
Call the physician right away and notify him.
- C.
Do nothing if patient is tolerating it except monitor for a decline in condition.
Correct Answer
A. Put a strip in his chart and make a note for the doctor to look at it.Explanation
If a patient has a short burst of Ventricular Tachycardia, it is important to put a strip in his chart and make a note for the doctor to look at it. This is because Ventricular Tachycardia can be a serious condition that may require medical intervention. By documenting the occurrence and notifying the doctor, appropriate measures can be taken to assess the patient's condition and determine the necessary treatment.Rate this question:
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- 20.
Which of the following is NOT a type of cardiac dysrhythmia?
- A.
Atrial fibrillation
- B.
Myocardial infarction
- C.
Ventricular tachycardia
- D.
Bradycardia
Correct Answer
B. Myocardial infarctionExplanation
A myocardial infarction, commonly known as a heart attack, is caused by blockage of blood flow to the heart muscle, resulting in damage to the heart tissue. While a heart attack can lead to cardiac dysrhythmias, it is not a type of dysrhythmia itself. Cardiac dysrhythmias are abnormalities in the heart's rhythm, including irregular heartbeats (like atrial fibrillation), abnormally fast heart rates (like ventricular tachycardia), or abnormally slow heart rates (like bradycardia).Rate this question:
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Oct 22, 2024Quiz Edited by
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Apr 21, 2011Quiz Created by
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