A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds.

Which of the following dysrhythmias is the client displaying

Atrial fibrillation.

Complete heart block

First-degree atrioventricular block

Premature atrial complexes

Answer and Explanation

The Correct Answer is C

. Answer and explanation.

The correct answer is choice C, first-degree atrioventricular block.

This is because the PR interval is longer than normal, which indicates a delay in the conduction of electrical impulses from the atria to the ventricles through the AV node. A normal PR interval is 0.12 to 0.2 seconds, or 3 to 5 small squares on the EKG strip.

In this case, the PR interval is 0.35 seconds, which is more than 5 small squares.

Choice A is wrong because atrial fibrillation is a type of arrhythmia where the atria beat irregularly and rapidly, producing chaotic and variable P waves and an irregular ventricular response.

There is no constant PR interval in atrial fibrillation.

Choice B is wrong because complete heart block is a type of arrhythmia where there is no conduction of electrical impulses from the atria to the ventricles, resulting in independent and dissociated atrial and ventricular rhythms.

There are no consistent P waves or PR intervals in complete heart block.

Choice D is wrong because premature atrial complexes are extra beats that originate from the atria and interrupt the normal sinus rhythm.

They produce abnormal P waves that are different from the sinus P waves, and may have a shorter or longer PR interval depending on the timing of the impulse.

However, they do not cause a constant prolongation of the PR interval.

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Correct Answer is B

Explanation

The correct answer is choice B. Apply direct pressure to the puncture site.

Choice A rationale:

Applying intermittent pressure 2.5 cm (1 inch) below the percutaneous skin site is not the best approach. This method may not effectively control the bleeding and could potentially dislodge the introducer sheath.

Choice B rationale:

Applying direct pressure to the puncture site is the most effective way to control bleeding. Direct pressure helps to promote clot formation and reduce blood flow to the area, which is crucial in managing postoperative bleeding.

Choice C rationale:

Elevating the affected extremity above the level of the heart is not appropriate in this situation. While elevation can reduce swelling, it does not address the immediate need to control active bleeding.

Choice D rationale:

Leaving the dressing undisturbed and notifying the physician immediately is not advisable. Immediate action to control the bleeding is necessary before notifying the physician. Delaying intervention could lead to significant blood loss.

A. Moving both crutches with the stronger leg forward first. B. Supporting his body weight while leaning on the axillary crutch pads C. Stepping with his affected leg first when going up stairs D. Positioning both hands on the grips with his elbows slightly flexed.

Correct Answer is D

Explanation

The correct answer is Choice d. Positioning both hands on the grips with his elbows slightly flexed.

Choice A rationale:

Moving both crutches with the stronger leg forward first is incorrect for a three-point gait.This describes a two-point gait,which is used when a client can bear weight on both legs.In a three-point gait,the client bears weight on the unaffected leg and the crutches,not the stronger leg.
This action would put excessive weight on the affected leg and could potentially compromise healing or cause further injury.

Choice B rationale:

Supporting his body weight while leaning on the axillary crutch pads is also incorrect.This can lead to nerve damage in the armpits and should be avoided.
The weight should be distributed through the hands and wrists,not the armpits.

Choice C rationale:

Stepping with his affected leg first when going up stairs is incorrect and potentially dangerous.The client should lead with the stronger leg when going up stairs to maintain balance and control.

Choice D rationale:

Positioning both hands on the grips with his elbows slightly flexed is the correct action for using crutches with a three-point gait.This allows for proper weight distribution,balance,and control of the crutches.
It also helps to prevent fatigue and strain in the arms and shoulders.

Key points to remember about the three-point gait:

Weight is borne on the unaffected leg and the crutches,not the affected leg.
The crutches and the unaffected leg move forward together,followed by the affected leg.
The client should look ahead,not down at their feet.
The client should take small,even steps.
The client should rest as needed.

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A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds. Which of the following dysrhythmias is the client displaying

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A nurse is reviewing a client’s cardiac rhythm strips and notes a constant P-R interval of 0.35 seconds.

Which of the following dysrhythmias is the client displaying