A nurse is teaching a group of clients about risk factors for developing atrial flutter. Which of the following clients should the nurse understand is at highest risk for developing atrial flutter?
The client who is out of work and has been experiencing increased stress.
The client who is recovering from a recent illness that caused vomiting and diarrhea.
The client whose mother and uncle were diagnosed with this same condition
The client who had a myocardial infarction and required stent placement.
The Correct Answer is D
Rationale:
A. While stress can contribute to arrhythmias, it is not the highest risk factor for atrial flutter. Stress alone is less likely to trigger atrial flutter without underlying cardiac disease.
B. The client who is recovering from a recent illness that caused vomiting and diarrhea – Electrolyte imbalances from vomiting and diarrhea can predispose to arrhythmias, but the risk is temporary and generally lower compared with structural heart disease.
C. The client whose mother and uncle were diagnosed with this same condition – A family history increases susceptibility, but genetic predisposition alone is not the highest risk factor for atrial flutter.
D. Structural heart disease, such as ischemic heart disease following a myocardial infarction (MI), is a major risk factor for developing atrial flutter because damaged atrial tissue can create abnormal electrical pathways that facilitate reentry circuits, leading to flutter.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. Hypokalemia (low potassium levels) can significantly affect skeletal and cardiac muscle function, leading to generalized fatigue, muscle weakness, cramping, and in severe cases, paralysis or life-threatening arrhythmias. Clients taking loop diuretics (e.g., furosemide) or thiazide diuretics are particularly at risk, as these medications increase potassium excretion in the urine. Monitoring for early signs of hypokalemia allows timely intervention with dietary potassium or supplementation.
B. Shortness of breath is more indicative of pulmonary congestion or fluid overload associated with heart failure rather than low potassium levels. While hypokalemia can indirectly affect cardiac function, dyspnea is not a primary manifestation.
C. Reduced urine output is associated with renal insufficiency, dehydration, or hypovolemia, not directly with hypokalemia from diuretic use.
D. Edema results from excess fluid retention in the interstitial space, often related to heart failure or renal disease, and is not a direct sign of hypokalemia.
Correct Answer is A
Explanation
Rationale:
A. Progressive lengthening of the PR interval indicates a first-degree or potentially worsening second-degree AV block. Notifying the provider is essential to prevent further conduction deterioration and potential progression to complete heart block, which can be life-threatening.
B. Increasing activity could exacerbate bradycardia or AV block symptoms (e.g., dizziness, syncope) and is unsafe in this context.
C. Beta-blockers like metoprolol can further slow AV conduction, potentially worsening the block, so giving it without provider consultation is unsafe.
D. Atropine is indicated for symptomatic bradycardia, but this patient currently has a normal HR (78) and is asymptomatic. Immediate administration is not warranted; the priority is assessment and provider notification.
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