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
- 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
- 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
- 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.
- 5.Most patients tolerate PACs with no necessary interventions.
- A.
True
- B.
False
- 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
- 7.Atrial fibrillation with a HR > 100 is considered an uncontrolled A-fib with rapid ventricular rhythm (RVR).
- A.
True
- B.
False
- 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
- 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
- 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
- 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
- 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
- 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
- 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.
- 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
- 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
- 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
- 18.Hemodynamically unstable means decreased CO, decreased BP, and decreased pulse.
- A.
True
- B.
False
- 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.
- 20.If your patient goes into Ventricular Fibrillation, it is important to ________________________.
- A.
Call the doctor right away and have him come see the patient.
- B.
Monitor the patient's condition for 5 minutes, if his condition does not improve, then call the doctor.
- C.
Call a code; the patient needs to be cardioconverted right away.
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