A client in an urgent care clinic is reports having heart palpitations, and occasional shortness of breath. A 12-lead electrocardiogram (ECG) shows regular P- waves in a sawtooth formation at a rate of 260 beats per minute, and a regular ventricular rate of 82 beats per minute. The nurse should understand that this ECG finding represents which of the following conditions?
Atrial fibrillation
Atrial flutter
Unstable angina
Premature atrial contractions
The Correct Answer is B
A. Atrial fibrillation is characterized by irregularly irregular rhythms with no distinct P-waves. Instead, it has a chaotic baseline with fibrillatory waves. The ventricular response can be irregular and variable. The description provided (regular P-waves in a sawtooth formation) does not match the typical appearance of atrial fibrillation, which lacks regular P-waves and has an irregular rhythm.
B. Atrial flutter is characterized by regular, sawtooth-shaped P-waves known as "F-waves" or "flutter waves." The classic pattern is referred to as "F-waves" with a "sawtooth" appearance, often seen in the inferior leads (II, III, aVF). The atrial rate is typically between 240 to 340 beats per minute, which fits the rate of 260 beats per minute in the description. The ventricular rate can be regular or irregular, depending on the degree of AV node conduction. A
C. Unstable angina is a clinical diagnosis of chest pain due to myocardial ischemia. It is not associated with specific ECG findings related to the P-wave morphology or rate. The ECG findings described do not correspond to unstable angina, which would typically present with ST-segment changes or other signs of myocardial ischemia rather than a specific P-wave pattern.
D. Premature atrial contractions (PACs) are early beats originating from the atria that interrupt the normal rhythm. They usually present as a single early beat with a different morphology of the P-wave compared to the sinus P-waves, but do not result in a regular sawtooth pattern or a sustained rhythm at high rates like the one described.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Radiofrequency catheter ablation involves the use of electrical energy (radiofrequency energy) delivered through a catheter to destroy or ablate the areas of the heart tissue responsible for the abnormal electrical signals causing atrial flutter. This destruction of tissue helps to interrupt the abnormal electrical pathways and restore normal rhythm.
B. The procedure for atrial flutter ablation does not use cold therapy. Instead, it uses radiofrequency energy (heat) to ablate the tissue. Cold therapy, or cryoablation, is a different technique that uses extreme cold to achieve similar effects but is not the standard approach for radiofrequency catheter ablation.
C. Radiofrequency catheter ablation does not involve removing clots. The primary purpose of the procedure is to ablate abnormal tissue causing arrhythmias, not to address clots. Managing clots may involve anticoagulant therapy or other treatments, but it is not the focus of ablation.
D. Radiofrequency catheter ablation does not stimulate the growth of new conduction pathways. Instead, it aims to destroy the abnormal conduction pathways responsible for arrhythmias.
Correct Answer is A
Explanation
A. Peaked T-waves and a widened QRS complex on an ECG are often signs of hyperkalemia, which is an elevated potassium level in the blood. This can be a serious complication of acute kidney injury (AKI), especially in the oliguric phase when the kidneys are unable to effectively excrete potassium.A
B. While fluid management is important in AKI, administering a bolus of normal saline is not the first priority in the presence of suspected hyperkalemia. The primary concern is to address the electrolyte imbalance.
C. Administering potassium chloride would worsen hyperkalemia and should be avoided.
D. Kayexalate is a medication used to treat hyperkalemia by exchanging sodium ions for potassium ions in the gastrointestinal tract. However, checking the potassium level is the first step in confirming the diagnosis and determining the appropriate treatment.
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