A nurse cares for a client who has a heart rate averaging 56 ...

[maychende]

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?
 
  a. Make certain that your bath water is warm.
  b. Avoid straining while having a bowel movement.
  c. Limit your intake of caffeinated drinks to one a day.
  d. Avoid strenuous exercise such as running.

Question 2

A nurse assesses a client's electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?
 
  a. The client has hyperkalemia causing irregular QRS complexes.
  b. Ventricular tachycardia is overriding the normal atrial rhythm.
  c. The client's chest leads are not making sufficient contact with the skin.
  d. Ventricular and atrial depolarizations are initiated from different sites.

[britb2u]

Answer to Question 1

ANS: B
Bearing down strenuously during a bowel movement is one type of Valsalva maneuver, which stimulates the vagus nerve and results in slowing of the heart rate. Such a response is not desirable in a person who has bradycardia. The other instructions are not appropriate for this condition.

Answer to Question 2

ANS: D
Normal rhythm shows one P wave preceding each QRS complex, indicating that all depolarization is initiated at the sinoatrial node. QRS complexes without a P wave indicate a different source of initiation of depolarization. This finding on an electrocardiograph tracing is not an indication of hyperkalemia, ventricular tachycardia, or disconnection of leads.

[maychende]

TYSM

[jomama]

Gracias!