A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?

Pacemaker spikes before each QRS complex

Pacemaker spikes after each QRS complex

Pacemaker spikes before each P wave

Pacemaker spikes with each T wave

Answer and Explanation

The Correct Answer is A

A. Pacemaker spikes before each QRS complex: This is the correct answer. In a client with a ventricular pacemaker, the pacemaker spikes should precede each QRS complex on the ECG strip. This indicates that the pacemaker is appropriately stimulating the ventricles to depolarize and initiate a heartbeat. The

presence of pacemaker spikes before each QRS complex signifies that the pacemaker is functioning properly and effectively pacing the ventricles.

B. Pacemaker spikes occurring after each QRS complex would suggest a malfunction or inappropriate timing of the pacemaker. In this scenario, the pacemaker would not be pacing the ventricles as intended. This would be an abnormal finding and would require further assessment and intervention.

C. Pacemaker spikes preceding each P wave would suggest pacing of the atria rather than the ventricles. This would indicate a different type of pacemaker (atrial pacemaker) or inappropriate pacing settings for a ventricular pacemaker. In either case, it would be considered abnormal for a ventricular pacemaker and would require evaluation and possibly reprogramming of the pacemaker.

D. Pacemaker spikes occurring with each T wave would be an abnormal finding and would suggest interference or oversensing by the pacemaker. This could lead to inappropriate pacing or dysrhythmias. It would require further investigation and correction to ensure proper pacemaker function.

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Correct Answer is []

Explanation

AF is characterized by irregular, rapid heartbeat (100 to 175 beats per minute (bpm) and the absence of distinct P waves.

Management of unstable atrial fibrillation include immediate pharmacological or electrical cardioversion and anticoagulation.

Atrial fibrillation leads to ineffective pumping and stasis of blood in the heart which increases the risk of stroke.

On initiating anticoagulation, PTT/INR is important to ensure that the drug is administered at doses that achieve the optimal therapeutic effect.

A. Prone Position B. Positioning supine with head elevated to 30-45 degrees C. Infusion of Albumin D. Transfusion of PRBC

Correct Answer is A

Explanation

A. Prone positioning involves turning the patient onto their abdomen to improve ventilation-perfusion matching by redistributing ventilation to the dorsal lung regions, where perfusion is typically better in ARDS patients.

B. Semi-recumbent positioning may be used to prevent aspiration and reduce the risk of VAP but is not as effective as prone positioning for improving V/Q matching.

C. Albumin infusion is not specific interventions for improving ventilation-perfusion matching in ARDS and should be considered based on other clinical indications.

D. Transfusion of packed red blood cells (PRBC) may be indicated in cases of severe anemia or hypoxemia due to inadequate oxygen-carrying capacity. However, it is not a primary intervention for improving ventilation-perfusion matching in ARDS

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A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?

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Correct Answer is []

Explanation

A client with acute respiratory distress syndrome (ARDS) shows no improvement despite increases in concentration in oxygen administered. What intervention should the nurse attempt which may improve ventilation-perfusion matching?

Correct Answer is A

Explanation

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