Chapter 26

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?

The nurse is analyzing a rhythm strip. What component of the ECG corresponds to the resting state of the patient’s heart?

The nursing educator is presenting a case study of an adult patient who has abnormal ventricular depolarization. This pathologic change would be most evident in what component of the ECG?

An adult patient with third-degree AV block is admitted to the cardiac care unit and placed on continuous cardiac monitoring. What rhythm characteristic will the ECG most likely show?

The nurse is writing a plan of care for a patient with a cardiac dysrhythmia. What would be the most appropriate goal for the patient?

A patient has returned to the cardiac care unit after having a permanent pacemaker implantation. For which potential complication should the nurse most closely assess this patient?

A patient the nurse is caring for has a permanent pacemaker implanted with the identification code beginning with VVI. What does this indicate?

The nurse is caring for an adult patient who has gone into ventricular fibrillation. When assisting with defibrillating the patient, what must the nurse do?

A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device. What would be the nurse’s best response?

A nurse is providing health education to a patient scheduled for cryoablation therapy. The nurse should describe what aspect of this treatment?

The nurse is caring for a patient who has just had an implantable cardioverter defibrillator (ICD) placed. What is the priority area for the nurse’s assessment?

During a patient’s care conference, the team is discussing whether the patient is a candidate for cardiac conduction surgery. What would be the most important criterion for a patient to have this surgery?

A nurse is caring for a patient who is exhibiting ventricular tachycardia (VT). Because the patient is pulseless, the nurse should prepare for what intervention?

A patient converts from normal sinus rhythm at 80 bpm to atrial fibrillation with a ventricular response at 166 bpm. Blood pressure is 162/74 mm Hg. Respiratory rate is 20 breaths per minute with normal chest expansion and clear lungs bilaterally. IV heparin and Cardizem are given. The nurse caring for the patient understands that the main goal of treatment is what?

The nurse and the other members of the team are caring for a patient who converted to ventricular fibrillation (VF). The patient was defibrillated unsuccessfully and the patient remains in VF. According to national standards, the nurse should anticipate the administration of what medication?

The nurse is planning discharge teaching for a patient with a newly inserted permanent pacemaker. What is the priority teaching point for this patient?

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?

An ECG has been ordered for a newly admitted patient. What should the nurse do prior to electrode placement?

The nurse is caring for a patient who has just undergone catheter ablation therapy. The nurse in the step-down unit should prioritize what assessment?

The ED nurse is caring for a patient who has gone into cardiac arrest. During external defibrillation, what action should the nurse perform?

A group of nurses are participating in orientation to a telemetry unit. What should the staff educator tell this class about ST segments?

The nurse is providing care to a patient who has just undergone an electrophysiologic (EP) study. The patient states that she is nervous about “things going wrong” during the procedure. What is the nurse’s best response?

New nurses on the telemetry unit have been paired with preceptors. One new nurse asks her preceptor to explain depolarization. What would be the best answer by the preceptor?

A cardiac care nurse is aware of factors that result in positive chronotropy. These factors would affect a patient’s cardiac function in what way?

The nurse is caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago. The nurse reviews the result of the patient’s most recent cardiac imaging, which notes the presence of scarring on the atria. How should the nurse best respond to this finding?

A patient is scheduled for catheter ablation therapy. When describing this procedure to the patient’s family, the nurse should address what aspect of the treatment?

A patient has undergone diagnostic testing and received a diagnosis of sinus bradycardia attributable to sinus node dysfunction. When planning this patient’s care, what nursing diagnosis is most appropriate?

The nurse is caring for a patient on telemetry. The patient’s ECG shows a shortened PR interval, slurring of the initial QRS deflection, and prolonged QRS duration. What does this ECG show?

A patient is undergoing preoperative teaching before his cardiac surgery and the nurse is aware that a temporary pacemaker will be placed later that day. What is the nurse’s responsibility in the care of the patient’s pacemaker?

The nurse caring for a patient whose sudden onset of sinus bradycardia is not responding adequately to atropine. What might be the treatment of choice for this patient?

The nurse is caring for a patient who has had a dysrhythmic event. The nurse is aware of the need to assess for signs of diminished cardiac output (CO). What change in status may signal to the nurse a decrease in cardiac output?

Following cardiac resuscitation, a patient has been placed in a state of mild hypothermia before being transferred to the cardiac intensive care unit. The nurse’s assessment reveals that the patient is experiencing neuromuscular paralysis. How should the nurse best respond?

The nurse is caring for a patient who has had a biventricular pacemaker implanted. When planning the patient’s care, the nurse should recognize what goal of this intervention?

When planning the care of a patient with an implanted pacemaker, what assessment should the nurse prioritize?

The nurse is assessing a patient who had a pacemaker implanted 4 weeks ago. During the patient’s most recent follow-up appointment, the nurse identifies data that suggest the patient may be socially isolated and depressed. What nursing diagnosis is suggested by these data?

The nurse is caring for a patient who is in the recovery room following the implantation of an ICD. The patient has developed ventricular tachycardia (VT). What should the nurse assess and document?

The staff educator is teaching a CPR class. Which of the following aspects of defibrillation should the educator stress to the class?

During a CPR class, a participant asks about the difference between cardioversion and defibrillation. What would be the instructor’s best response?

A patient is admitted to the cardiac care unit for an electrophysiology (EP) study. What goal should guide the planning and execution of the patient’s care?

A patient calls his cardiologist’s office and talks to the nurse. He is concerned because he feels he is being defibrillated too often. The nurse tells the patient to come to the office to be evaluated because the nurse knows that the most frequent complication of ICD therapy is what?