Author Question: On admitting a client, the nurse finds that there is a history of myocardial ischemia. The most ... (Read 33 times)

nenivikky · **on:** Jul 23, 2018

On admitting a client, the nurse finds that there is a history of myocardial ischemia. The most disconcerting dysrhythmia for electrocardiography to reveal is:

1. Sinus bradycardia
2. Sinus dysrhythmia
3. Ventricular tachycardia
4. Atrial fibrillation

Question 2

A 64-year-old client is seen in the emergency department for palpitations and mild shortness of breath.

The electrocardiogram (ECG) reveals a normal P wave, P-R interval, and QRS complex with a regular rhythm and rate of 108 beats per minute. The nurse should recognize this cardiac dysrhythmia as:
1. Sinus dysrhythmia
2. Sinus tachycardia
3. Supraventricular tachycardia
4. Ventricular tachycardia

upturnedfurball · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: 3
Ventricular tachycardia would be the most disconcerting dysrhythmia of the four options. Ven-tricular tachycardia results in a decreased cardiac output; it may lead to severe hypotension and loss of pulse rate and consciousness. Sinus bradycardia would not be of concern for this client. It is of no clinical significance unless it is associated with signs and symptoms of a decreased car-diac output. Sinus dysrhythmia is of no clinical significance unless dizziness occurs with a de-creased rate. Atrial fibrillation is not as detrimental as ventricular tachycardia.

Answer to Question 2

ANS: 2
The client is experiencing sinus tachycardia. The rhythm is regular with a normal P wave, normal QRS complex, and a rate of 100 to 180 beats per minute. A sinus dysrhythmia has a rate of 60 to 100 beats per minute and slows during inspiration and increases with expiration. The client is not experiencing a sinus dysrhythmia. With supraventricular tachycardia, the heart rate is 150 to 250 beats per minute, the P wave may be buried in the preceding T wave, and the P-R interval is var-iable. This client is not experiencing supraventricular tachycardia. With ventricular tachycardia the rhythm is slightly irregular at a rate of 100 to 200 beats per minute, the P wave is absent, the P-R interval is absent, and the QRS complex is wide. This client is not experiencing ventricular tachycardia.