Chapter 26: Management Of Patients With Dysrhythmias And Conduction Problems

Front 1

A ______ effect increases the force of myocardial contraction

Back 1

positive inotropic

Front 2

A ______ effect increases the heart rate.

Back 2

positive chronotropic

Front 3

A _____ effect will usually help ____respiratory rate and will increase blood flow through the kidneys, so fluid output will increase.

Back 3

positive inotropic

slow

Front 4

_________ is a dysrhythmia that proceeds normally through the conduction pathway but at a faster than usual rate (100 to 150 beats/minute)

Back 4

Sinus tachycardia

Front 5

_______ is a disorder in which a single atrial impulse outside the SA node causes the atria to contract at an exceedingly rapid rate.

Back 5

Atrial flutter

Front 6

A client presents to the emergency department via ambulance with a heart rate of 210 beats/minute and a sawtooth waveform pattern per cardiac monitor. The nurse is most correct to alert the medical team of the presence of a client with which disorder?

Back 6

:Atrial flutter

Front 7

_______is the absence of cardiac function and can indicate death.

Back 7

Asystole

Front 8

_________contraction indicates an early electric impulse and does not necessarily produce an exceedingly rapid heart rate.

Back 8

Premature ventricular

Front 9

________ is the inefficient quivering of the ventricles and indicative of a dying heart

Back 9

ventricular fibrillation

Front 10

_______is used during pulseless ventricular tachycardia and ventricular fibrillation.

Back 10

Defibrillation

Front 11

A client has a medical diagnosis of an advanced AV block and is symptomatic due to a slow heart rate. With what initial treatment(s) should the nurse be prepared to assist?

Back 11

IV bolus of atropine or temporary pacing

Front 12

Which of the following terms is used to describe a tachycardia characterized by abrupt onset, abrupt cessation, and a QRS of normal duration?

Back 12

Paroxysmal atrial tachycardia

Front 13

_______ causes a rapid, disorganized, and uncoordinated twitching of atrial musculature.

Back 13

Atrial fibrillation

Front 14

A patient admitted to the telemetry unit has a serum potassium level of 6.6 mEq/L. Which of the following electrocardiographic (ECG) characteristics is commonly associated with this laboratory finding?

Back 14

Peaked T waves

Front 15

The T wave is an ECG characteristic reflecting _______of the ______.

Back 15

repolarization

ventricles

Front 16

_____ may become tall or “peaked” if a patient’s serum potassium level is _____.

Back 16

T wave

High

Front 17

The U wave is an ECG waveform characteristic that may reflect ________.

Back 17

Purkinje fiber repolarazation

Front 18

_____ is usually seen when a patient’s serum potassium level is low.

Back 18

U wave

Front 19

_______ is used to treat symptomatic bradycardia.

Back 19

I.V. push atropine

Front 20

_________ is used to treat heart failure and low cardiac output.

Back 20

Dobutamine

Front 21

______- is used to treat ventricular fibrillation and unstable ventricular tachycardia.

Back 21

Amiodarone

Front 22

______ is used to treat ventricular ectopy, ventricular tachycardia, and ventricular fibrillation.

Back 22

Lidocaine

Front 23

Causes of sinus tachycardia include:

Back 23

physiologic or psychological stress ,acute blood loss, anemia, shock, hypovolemia, fever, and exercise

Front 24

Vagal stimulation, sleep, hypothyroidism, athletic training, and Digoxin all will cause a

Back 24

slow heart rate

Front 25

In adults, the normal range for the PR is______ seconds.

Back 25

0.12 to 0.20

Front 26

A PR internal of 0.24 seconds would indicate a _____.

Back 26

first-degree heart block

Front 27

A client with atrial fibrillation, who does not respond to conventional treatment measures and who is not a candidate for cardioversion, would have what procedure recommended?

Back 27

Maze procedure

Front 28

The QRS complex on the ECG strip represents _____

Back 28

ventricular depolarization

Front 29

A patient with hypertension has a newly diagnosed atrial fibrillation. What medication does the nurse anticipate administering to prevent the complication of atrial thrombi?

Back 29

Warfarin (Coumadin)

Front 30

_______ destroys specific cells that are the cause or central conduction route of a tachydysrhythmia.

Back 30

Catheter ablation

Front 31

A patient has had several episodes of recurrent tachydysrhythmias over the last 5 months and medication therapy has not been effective. What procedure should the nurse prepare the patient for?

Back 31

Catheter ablation

Front 32

The patient is told that she has second-degree AV block with symptomatic bradycardia. The patient will be treated with an anticholinergic that blocks the effects of the vagal nerve. Choose the most likely drug that will be prescribed.

Back 32

atropine sulfate

Front 33

Causes of premature atrial complexes include:

Back 33

caffeine, alcohol, nicotine, stretched atrial myocardium (e.g., as in hypervolemia), anxiety, hypokalemia (low potassium level), hypermetabolic states (e.g., with pregnancy), or atrial ischemia, injury, or infarction.

Front 34

Premature ventricular contractions (PVCs) are considered precursors of ventricular tachycardia (VT) when they:

Back 34

occur at a rate of more than six per minute

Front 35

During electrophysiology studies, the patient is _____ and may experience symptoms related to the ______, reproduced under controlled conditions

Back 35

awake

arrhythmia.

Front 36

In the acute care setting, when ventricular fibrillation is noted, the nurse should: ( 2)

Back 36

call for assistance and defibrillate the patient as soon as possible.

Front 37

If defibrillation is not readily available,____ is begun until the patient can be defibrillated, followed by advanced cardiovascular life support (ACLS) intervention.

Back 37

CPR

Front 38

advanced cardiovascular life support (ACLS) intervention, which includes

Back 38

endotracheal intubation and administration of epinephrine.

Front 39

The nurse is assessing a patient with a probable diagnosis of first-degree AV block. He is aware that this dysrhythmia is evident on an ECG strip by which of the following?

Back 39

Delayed conduction, producing a prolonged PR interval

Front 40

If symptomatic, the treatment for bradycardia and symptomatic junctional rhythm is :

Back 40

the patient may be treated with pacing (temporary or permanent), IV atropine, or epinephrine

Front 41

_____ a cholinergic blocking agent, is given intravenously (IV) to increase a dangerously slow heart rate.

Back 41

Atropine sulfate,

Front 42

____ is a rhythm in which every other complex is a PVC

Back 42

Ventricular Bigeminy

Front 43

Which of the following is a potential cause of premature ventricular complexes (PVCs)

Back 43

hypokalemia

Front 44

_____ caused by cardiac ischemia or infarction, increased workload on the heart (eg, exercise, fever, hypervolemia, heart failure, tachycardia), digitalis toxicity, acidosis, or electrolyte imbalances, especially hypokalemia

Back 44

premature ventricular complexes

Front 45

Clients with persistent atrial fibrillation are prescribed ______

Back 45

anticoagulation therapy, to reduce the risk of emboli formation associated with ineffective circulation.

Front 46

Atrial fibrillation may be found in people with acute moderate to heavy ingestion of_____.

Back 46

alcohol

Front 47

the impulse travels to the AV node in ____seconds

Back 47

0.12 to 0.2

Front 48

The nurse in the intensive care unit (ICU) hears an alarm sound in the patient’s room. Arriving in the room, the patient is unresponsive, without a pulse, and a flat line on the monitor. What is the first action by the nurse?

Back 48

Begin cardiopulmonary resuscitation (CPR)

Front 49

Prior to cardioversion, cardiac medications are held, and the client is sedated with a medication .

Back 49

Valium

Front 50

One of the reasons for lack of pacemaker spikes is _____.

Back 50

faulty monitoring equipment.

Front 51

A healthy 46-year-old woman is seeing her health care provider for her annual physical examination. While the nurse is taking the patient's vital signs, the patient states, “Occasionally, my heart skips a beat. Is this normal?” The nurse explains that this feeling is caused by which of the following?

Back 51

Premature atrial complex

Front 52

As a long-acting, selective beta1-adrenergic blocker, atenolol

Back 52

decreases cardiac output and systolic and diastolic blood pressure;

Front 53

The QT interval is usually _____seconds in duration

Back 53

0.32 to 0.40

Front 54

_____ is a nonemergency procedure done by a physician to stop rapid, but not necessarily life-threatening, atrial dysrhythmias

Back 54

Elective electrical cardioversion

Front 55

ECG characteristics of atrial fibrillation include:

Back 55

an atrial rate of 300 to 400, a nonmeasurable PR interval, irregular rhythm, and no discernible P waves

Front 56

The P wave is an ECG characteristic reflecting conduction of an electrical impulse through the ___.

Back 56

atria

Front 57

The PR interval is a component of an ECG tracing reflecting conduction of an electrical impulse through the _____.

Back 57

av node

Front 58

The QT interval is an ECG characteristic reflecting the time from_____.

Back 58

the time from ventricular depolarization to repolorization.

Front 59

The nurse expects to see which of the following characteristics on an ECG strip for a patient who has third-degree AV block?

Back 59

More P waves than QRS complexes

Front 60

With cardioversion, the Defibrillator should be set to deliver a shock during ____.

Back 60

the QRS complex.