Cardiac Care

The nurse is caring for a client after pacemaker insertion. Which nursing intervention is most appropriate at this time?

• Reinforcing the pressure dressing as needed

• Encouraging range-of-motion exercises of the involved arm

• Assessing the incision for any redness, swelling, or discharge

• Applying wet-to-dry dressings every 4 hours to the insertion site

The patient has atrial fibrillation with a rapid ventricular response. The nurse knows to prepare for which treatment if an electrical treatment is planned for this patient?

• Defibrillation

• Synchronized cardioversion

• Automatic external defibrillator (AED)

• Implantable cardioverter-defibrillator (ICD)

The patient has hypokalemia, and the nurse obtains the following measurements on the rhythm strip: Heart rate of 86 with a regular rhythm; the P wave is normal shape; the PR interval is 0.24 sec. The QRS is normal. How should the nurse document this rhythm?

• First-degree AV block

• Second-degree AV block

• Premature atrial contraction (PAC)

• Premature ventricular contraction (PVC)

The nurse has obtained this rhythm strip from her patient's monitor. Which description of this ECG is correct?

• Sinus tachycardia

• Sinus bradycardia

• Ventricular fibrillation

• Ventricular tachycardia

A healthy but anxious 24-year-old college student reports tingling sensations, palpitations, and sore chest muscles. Deep, rapid breathing and carpal spasms are noted. What action might the nurse take?

• Notify the health care provider immediately

• Administer supplemental oxygen

• Have the student breathe into a paper bag

• Obtain an order for an anxiolytic medication

The nurse is caring for a client who is on the cardiac monitor because of these symptoms: syncope, dizziness, and intermittent episodes of palpitations. Below is a display of what the nurse sees on the cardiac monitor. What should the nurse do first?

• Call the Rapid Response Team

• Obtain the automated external defibrillator

• Assess the client and take vital signs

• Check the adherence of the gel pads on the chest

The clinic nurse is evaluating a client who had coronary artery stenting through the right femoral artery a week previously and is taking metoprolol, clopidogrel, and aspirin. Which information reported by the client is most important to report to the health care provider?

• Stools have been black in color

• Bruising is present at the right groin

• Home blood pressure today was 104/52 mm Hg

• Home radial pulse rate has been 60 beats/min

At 10:00 AM, a hospitalized client receives a new order for transesophageal echocardiography as soon as possible. Which prescribed action will the nurse take first?

• Put the client on 'nothing by mouth' (NPO) status

• Teach the client about the procedure

• Insert an IV catheter in the client's forearm

• Attach the client to a cardiac monitor

A client in the emergency department who is being monitored with a portable cardiac monitor/defibrillator develops this rhythm. Breathing and pulse are assessed. Which action will the nurse take first?

• Defibrillate at 200 joules

• Start cardiopulmonary resuscitation (CPR)

• Administer epinephrine 1 mg IV

• Intubate and manually ventilate

The nurse is ambulating a cardiac surgery client whose heart rate suddenly increases to 146 beats/min. In which order will the nurse take the following actions?

• Call the client's health care provider

• Have the client sit down

• Check the client's blood pressure

• Administer as needed (PRN) oxygen by nasal cannula