After the nurse gives IV atropine to a patient with symptomatic type 1. second-degree atrioventricular (AV) block, which finding indicates that the drug has been effective?
Increase in the patient's heart rate.
Decrease in premature ventricular contractions.
Increase in strength of peripheral pulses.
Decrease in premature atrial contractions
The Correct Answer is A
Atropine is an anticholinergic medication that acts by blocking the effects of the parasympathetic nervous system on the heart, leading to an increase in heart rate (positive chronotropic effect) and conduction velocity (positive dromotropic effect). In patients with symptomatic type 1 second degree atrioventricular (AV) block (also known as Mobitz type 1 or Wenckebach), the electrical impulses between the atria and ventricles are delayed or blocked intermittently, resulting in a progressive lengthening of the PR interval until a ventricular beat is dropped.
When atropine is administered to a patient with symptomatic type 1 AV block, it can counteract the increased vagal tone that contributes to the block and help improve the conduction through the AV node. As a result, the heart rate is expected to increase, which is a positive response to the medication.
The other options listed (B) Decrease in premature ventricular contractions, (C) Increase in strength of peripheral pulses, and (D) Decrease in premature atrial contractions, are not directly related to the effect of atropine on type 1 AV block and are not typical findings associated with atropine administration in this context. The main goal of administering atropine in this situation is to increase the heart rate and improve the AV conduction to alleviate symptoms associated with the AV block.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
B-type natriuretic peptide (BNP) is a diagnostic blood test that can be most useful to the nurse in determining whether a client admitted with acute shortness of breath has heart failure.
BNP is a hormone produced by the heart in response to increased pressure and volume in the heart, especially in cases of heart failure. When the heart is under stress, such as in heart failure, it releases BNP into the bloodstream. Elevated levels of BNP are strongly indicative of heart failure, and the testis particularly helpful in differentiating heart failure from other conditions that may present withsimilar symptoms, such as pulmonary disorders.
When a patient presents with acute shortness of breath, the BNP test can provide valuable information to help guide the diagnosis and treatment. If the BNP level is elevated, it suggests that heart failure is likely the cause of the symptoms, and appropriate interventions can be initiated promptly.
While other diagnostic tests like serum troponin (A) are important for assessing heart damage in conditions like myocardial infarction (heart attack), they may not be as specific for heart failure.
Arterial blood gases (B) are helpful in evaluating gas exchange and acid-base balance, especially in patients with respiratory distress, but they are not specific for diagnosing heart failure.
A 12-lead electrocardiogram (ECG) (C) can provide valuable information about the heart's electrical activity and any signs of acute myocardial infarction or other cardiac abnormalities, but it is not the primary test for diagnosing heart failure. An ECG can support the diagnosis if specific changes suggestive of heart failure are present, but the BNP test provides more direct evidence for heart failure diagnosis.
Correct Answer is B
Explanation
The patient is apneic (not breathing) and has no palpable pulses, indicating a cardiac arrest or severe cardiovascular compromise. In this situation, the most appropriate action for the nurse to take next is to start cardiopulmonary resuscitation (CPR) immediately.
CPR is a life-saving procedure that combines chest compressions and rescue breaths to circulate oxygenated blood to vital organs when the heart is not effectively pumping. In the case of cardiac arrest, early initiation of CPR is critical to improve the chances of survival and minimize potential brain damage.
The heart monitor shows sinus tachycardia, rate 132, which suggests that the electrical impulses are reaching the heart, but the heart is not effectively pumping blood due to the lack of a palpable pulse. This condition requires immediate intervention with CPR rather than other treatments such as synchronized cardioversion (option A) or administering atropine (option D).
While applying supplemental oxygen via a non-rebreather mask (option C) is generally important in many emergency situations, it is not the immediate priority when a patient is apneic and has no palpable pulses. In such cases, CPR takes precedence to restore circulation and maintain oxygen delivery to the body's vital organs.
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