Cardiac Dysrhythmias: Chapter 19, Care of Patients with Cardiac Disorders

Question 1 of 9

 Report content error

Which factor may cause sinus tachycardia? Select all that apply. One, some, or all responses may be correct.

• Correct
  • FeverOne cause of sinus tachycardia is fever.
• Correct
  • StressOne cause of sinus tachycardia is stress.
• • Vagal maneuverBradycardia can occur if a person uses the vagal maneuver.
• Correct
  • Pain or discomfortOne cause of sinus tachycardia is pain or discomfort.
• • Use of a beta blockerBradycardia can occur if a person takes a beta blocker.

Question 2 of 9

 Report content error

Atrial fibrillation predisposes a patient to which issue?

• • CracklesCrackles are associated with fluid in the lungs.
• • BradycardiaAtrial fibrillation is more associated with tachycardia than bradycardia.
• Correct
  • Clot formationThe major risk associated with atrial fibrillation is clot formation.
• • Pericardial friction rubPericardial friction rub is associated with pericarditis.

Question 3 of 9

 Report content error

Which symptom may a patient experience when the heart is not stimulated to contract at the correct rate or in an effective manner?

• Correct
  • Chest painSymptoms the patient may experience include dizziness, palpitations (abnormally rapid throbbing or fluttering of the heart), fatigue, chest pain, hypotension, and loss of consciousness; death may occur.
• • HypertensionWhen the heart is not stimulated to contract at the correct rate or in an effective manner, the patient may experience hypotension because of the decrease in cardiac output.
• • BradycardiaWhen the heart is not stimulated to contract at the correct rate or in an effective manner, the patient may experience a rapid or fluttering heartbeat. Bradycardia is a slow heart rate of less than 60 beats per minute (bpm).
• • Increased energyWhen the heart is not stimulated to contract at the correct rate or in an effective manner, the patient may experience fatigue because of a decrease in cardiac output.

Question 4 of 9

 Report content error

Which factor would the nurse include as a precipitating factor in the discharge instructions for a patient who has an irregular or rapid heartbeat?

• Correct
  • CaffeineAny time a person states that they have noticed an irregular or rapid heartbeat, ask how much caffeine is being consumed each day. If consumption is minimal, ask about medications being taken, such as decongestants. Ask about the person’s stress level. The problem may disappear when the precipitating factor is removed.
• • Saturated fatsSaturated fats are directly related to cardiovascular disease but do not cause irregular or rapid heartbeats.
• • SedativesSedatives promote rest and relaxation rather than a rapid or irregular heartbeat.
• • AntihistaminesPseudoephedrine in decongestants can precipitate irregular or rapid heartbeats. Antihistamines alone do not contain pseudoephedrine.

Question 5 of 9

 Report content error

Which cardiac rhythm can quickly deteriorate into ventricular fibrillation (VF) or cardiac standstill?

• Correct
  • Ventricular tachycardia (VT)VT can quickly deteriorate into VF or cardiac standstill.
• • Atrial fibrillationThis rhythm does not deteriorate into VF or cardiac standstill.
• • AsystoleAsystole is cardiac standstill. It is pulseless and cannot deteriorate any further.
• • Premature atrial contractions (PAC)PACs are common and do not often produce symptoms. They are benign and do not deteriorate into a lethal rhythm.

Question 6 of 9

 Report content error

Which statement about ventricular fibrillation (VF) offers the best explanation for why it produces no cardiac output?

• • Chaotic rhythmVentricular fibrillation is a chaotic random firing of all the ventricular cells. This is a true statement but does not cause absence of cardiac output.
• Correct
  • Ventricles quivering/not contractingThe ventricles quiver rather than contract; there is no cardiac output. Contraction of the ventricles directly contributes to cardiac output. Quivering has no force, and the blood becomes stagnant where it is.
• • Atria not firingThis is a true statement concerning VF because it is a ventricular rhythm but does not cause absence of cardiac output. The cardiac output is a direct result of a contracting ventricle.
• • No determinable intervals in rhythmThis is a true statement but does not cause absence of cardiac output. The electrocardiogram shows coarse electrical waveforms varying in size and shape, and no intervals can be determined.

Question 7 of 9

 Report content error

When would the nurse who notices premature ventricular contractions (PVCs) on the rhythm strip of a patient report this finding as a potential concern to the healthcare provider? Select all that apply. One, some, or all responses may be correct.

• • One PVC occurs over a minute.A few PVCs are not abnormal. When there are more than six or seven in a minute, cardiac output may fall.
• Correct
  • The PVCs have multiple shapes.PVCs should be reported to the healthcare provider when they have multiple shapes.
• Correct
  • Seven PVCs occur over a minute.A few PVCs are not abnormal, but when there are more than six or seven in a minute, cardiac output may fall. PVCs should be reported to the healthcare provider when they occur frequently.
• Correct
  • Three PVCs occur in a row.PVCs should be reported to the healthcare provider when they occur frequently. Three or more PVCs in a row are considered ventricular tachycardia.
• Correct
  • The patient complains of dizziness and is hypotensive.PVCs should be reported to the healthcare provider when the patient shows signs of decreased cardiac output. Dizziness and hypotension are signs of decreased cardiac output.

Question 8 of 9

 Report content error

Which nursing consideration is included in preparation for synchronized cardioversion? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Signed informed consentSynchronized cardioversion is considered an invasive treatment and a signed informed consent is required.
• Correct
  • Resuscitation equipment on handThere is a risk for a patient’s rhythm to deteriorate into a lethal rhythm; thus resuscitation equipment must be on hand.
• Correct
  • Close, constant patient monitoring of vital signsThe patient must be monitored for response to treatment, including heart rate, rhythm, and blood pressure. Monitoring of vital signs allows the nurse to know if the patient is hemodynamically stable.
• Correct
  • Administration of a preprocedural sedativeThe electrical shock involved in synchronized cardioversion is very uncomfortable to the patient who is already in an anxious state because of the nature of the illness. A sedative before the procedure helps the patient to relax.
• Correct
  • Monitoring for response to treatmentThe patient must be monitored for response to treatment to allow the provider to know if the patient is stable. This is done through vital signs and assessment for signs and symptoms of decreased cardiac output.

Question 9 of 9

 Report content error

The nurse must monitor for which symptom related to cardiac tamponade when epicardial pacer wires are pulled? Select all that apply. One, some, or all responses may be correct.

• Correct
  • Sharp chest painThe nurse will monitor patients for signs and symptoms of bleeding into the pericardial sac, including sharp chest pain.
• Correct
  • DyspneaThe nurse will monitor patients for signs and symptoms of bleeding into the pericardial sac, including dyspnea.
• • Flushed skinCyanosis, not flushing skin, is a sign of cardiac tamponade.
• • HypotensionHypertension, not hypotension, is a sign of cardiac tamponade.
• Correct
  • TachycardiaThe nurse will monitor patients for signs and symptoms of bleeding into the pericardial sac, including tachycardia. The heart speeds up to compensate for the lack of perfusion because of cardiac tamponade.