Author Question: A patient reports dizziness and shortness of breath for several days. During cardiac monitoring in ... (Read 127 times)

anshika · **on:** Jun 25, 2018

A patient reports dizziness and shortness of breath for several days. During cardiac monitoring in the emergency department (ED), the nurse obtains the following electrocardiographi c (ECG) tracing.

The nurse interprets this heart rhythm as
a. junctional escape rhythm.
b. accelerated idioventricular rhythm.
c. third-degree atrioventricular (AV) block.
d. sinus rhythm with premature atrial contractions (PACs).

Question 2

Which action by a new registered nurse (RN) who is orienting to the progressive care unit indicates a good understanding of the treatment of cardiac dysrhythmias?

a. Injects IV adenosine (Adenocard) over 2 seconds to a patient with supraventricular tachycardia
b. Obtains the defibrillator and quickly brings it to the bedside of a patient whose monitor shows asystole
c. Turns the synchronizer switch to the on position before defibrillating a patient with ventricular fibrillation
d. Gives the prescribed dose of diltiazem (Cardizem) to a patient with new-onset type II second degree AV block

essyface1 · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: C
The inconsistency between the atrial and ventricular rates and the variable P-R interval indicate that the rhythm is third-degree AV block. Sinus rhythm with PACs will have a normal rate and consistent P-R intervals with occasional PACs. An accelerated idioventricular rhythm will not have visible P waves.

Answer to Question 2

ANS: A
Adenosine must be given over 1 to 2 seconds to be effective. The other actions indicate a need for more education about treatment of cardiac dysrhythmias. The RN should hold the diltiazem until talking to the health care provider. The treatment for asystole is immediate CPR. The synchronizer switch should be off when defibrillating.