A nurse cares for a client with atrial fibrillation who reports ...

[dmcintosh]

A nurse cares for a client with atrial fibrillation who reports fatigue when completing activities of daily living. What interventions should the nurse implement to address this client's concerns?
 
  a. Administer oxygen therapy at 2 liters per nasal cannula.
  b. Provide the client with a sleeping pill to stimulate rest.
  c. Schedule periods of exercise and rest during the day.
  d. Ask unlicensed assistive personnel to help bathe the client.

Question 2

A nurse cares for a client with an intravenous temporary pacemaker for bradycardia. The nurse observes the presence of a pacing spike but no QRS complex on the client's electrocardiogram. Which action should the nurse take next?
 
  a. Administer intravenous diltiazem (Cardizem).
  b. Assess vital signs and level of consciousness.
  c. Administer sublingual nitroglycerin.
  d. Assess capillary refill and temperature.

[mcinincha279]

Answer to Question 1

ANS: C
Clients who have atrial fibrillation are at risk for decreased cardiac output and fatigue when completing activities of daily living. The nurse should schedule periods of exercise and rest during the day to decrease fatigue. The other interventions will not assist the client with self-care activities.

Answer to Question 2

ANS: B
In temporary pacing, the wires are threaded onto the epicardial surface of the heart and exit through the chest wall. The pacemaker spike should be followed immediately by a QRS complex. Pacing spikes seen without subsequent QRS complexes imply loss of capture. If there is no capture, then there is no ventricular depolarization and contraction. The nurse should assess for cardiac output via vital signs and level of consciousness. The other interventions would not determine if the client is tolerating the loss of capture.

[dmcintosh]

Excellent

[FergA]

Thanks for the timely response, appreciate it