Which client in a cardiac step-down unit would the nurse monitor ...

[hbsimmons88]

Which client in a cardiac step-down unit would the nurse monitor most closely for the development of cerebral vascular accident (CVA) or stroke?
 
  1. An 80-year-old client whose cardiac monitor reveals bradycardia with a rate of 58
  2. A 56-year-old client with a PR interval of 0.22 seconds
  3. A 37-year-old client with recent-onset atrial fibrillation
  4. A 63-year-old client with occasional premature ventricular contractions (PVCs)

Question 2

A client presents to the emergency department (ED) with dyspnea, diaphoresis, and lightheadedness. The cardiac monitor reveals paroxysmal supraventricular tachycardia (SVT).
 
  Which class of antiarrhythmic drug does the nurse anticipate will be administered?
  1. A calcium channel blocker
  2. A class IC drug
  3. A class IB drug
  4. A class IA drug

[popopong]

Answer to Question 1

Correct Answer: 3
Rationale 1: Bradyarrhythmias are common in older adults, and a heart rate of 58 is not the most significant indicator of risk of stroke.
Rationale 2: Prolongation of the PR interval is not normal but is not a precursor of stroke.
Rationale 3: Atrial fibrillation slows the movement of blood through the chambers of the heart and may result in clot formation. If a clot is ejected from the heart into the systemic circulation, a stroke may occur.
Rationale 4: Occasional PVCs are common and are not a precursor of stroke.
Global Rationale: Atrial fibrillation slows the movement of blood through the chambers of the heart and may result in clot formation. If a clot is ejected from the heart into the systemic circulation, a stroke may occur. Bradyarrhythmias are common in older adults, and a heart rate of 58 is not the most significant indicator of risk of stroke. Prolongation of the PR interval is not normal but is not a precursor of stroke. Occasional PVCs are common and are not a precursor of stroke.

Answer to Question 2

Correct Answer: 1
Rationale 1: Calcium channel blockers are class IV antiarrhythmic drugs and are administered to treat SVT.
Rationale 2: Class IC drugs are used for severe ventricular dysrhythmias.
Rationale 3: Class IB drugs are used for severe ventricular dysrhythmias.
Rationale 4: Class IA drugs are given for atrial fibrillation, premature atrial contractions, premature ventricular contractions, and tachycardia.
Global Rationale: Calcium channel blockers are class IV antiarrhythmic drugs and are administered to treat SVT. Class IC and Class IB drugs are used for severe ventricular dysrhythmias. Class IA drugs are given for atrial fibrillation, premature atrial contractions, premature ventricular contractions, and tachycardia.

[hbsimmons88]

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[popopong]

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