Mr Jones came to the ER complaining of chest palpitations. He states his heart feels like it is "racing". The nurse found the following rhythm on the monitor. What is the next step would the nurse expect to take first?
Defibrillate
Ask him to blow into a syringe
Draw troponins
Give amiodarone
The Correct Answer is B
B This maneuver, called the Valsalva maneuver, can sometimes help to restore normal heart rhythm in cases of SVT. It involves blowing forcefully into a syringe or performing a similar action that increases intra-abdominal pressure, which can stimulate the vagus nerve and help to slow down the heart rate.
A Defibrillation is a treatment used for life-threatening cardiac arrhythmias, particularly ventricular fibrillation or pulseless ventricular tachycardia. It involves delivering a therapeutic dose of electrical energy to the heart with a device called a defibrillator.
C Drawing troponin levels may be appropriate if there is suspicion of myocardial infarction as the cause of chest palpitations or if there are other symptoms suggestive of acute coronary syndrome. However, in the context of SVT presenting with chest palpitations and a racing heart, the priority is to address the arrhythmia first
D Amiodarone is an antiarrhythmic medication used to treat various types of cardiac arrhythmias, including ventricular and supraventricular arrhythmias. While it can be effective in certain cases of SVT, it is not typically the first-line treatment or the immediate next step in managing SVT in the emergency department.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. Respiratory acidosis- The pH is acidic, and the PaCO2 is elevated, indicating respiratory acidosis. The client's hypoventilation (respiratory rate of 7/min) is causing retention of carbon dioxide, leading to respiratory acidosis.
A. Metabolic alkalosis- The ABG values do not support a diagnosis of metabolic alkalosis. The pH is acidic, and the base excess is negative, indicating a mild metabolic acidosis.
B. Respiratory alkalosis- The ABG values do not support a diagnosis of respiratory alkalosis. The pH is acidic, and the PaCO2 is elevated, indicating respiratory acidosis rather than alkalosis.
D. Metabolic acidosis- While there is evidence of a mild metabolic acidosis indicated by the negative base excess, the primary disturbance in this case is respiratory acidosis, as evidenced by the low pH and elevated PaCO2.
Correct Answer is ["A","B","C","E"]
Explanation
A. Chronic hypertension is a significant risk factor for the development of various cardiac diseases, including coronary artery disease, left ventricular hypertrophy, heart failure, and arrhythmias. The increased workload on the heart caused by hypertension can lead to myocardial remodeling, impaired cardiac function, and ultimately heart disease.
B. Chronic hypertension can cause damage to the kidneys over time, leading to renal insufficiency or chronic kidney disease. The elevated blood pressure damages the delicate blood vessels in the kidneys, impairing their ability to filter waste products and regulate fluid and electrolyte balance. Persistent hypertension can ultimately lead to kidney dysfunction and renal failure.
C. Hypertension is a major risk factor for the development of stroke, particularly ischemic stroke (caused by a blockage in a blood vessel supplying the brain) and hemorrhagic stroke (caused by bleeding into the brain). Chronic hypertension can damage blood vessels in the brain, leading to the formation of blood clots or weakening of vessel walls, increasing the risk of stroke.
E. Chronic hypertension is a significant risk factor for the development of atrial fibrillation, a type of irregular heart rhythm characterized by rapid and chaotic electrical activity in the upper chambers of the heart (atria). The structural changes in the heart caused by hypertension, such as left atrial enlargement and fibrosis, can predispose individuals to atrial fibrillation.
D. Familial hypercholesterolemia is a genetic disorder characterized by high levels of LDL cholesterol in the blood. While chronic hypertension itself does not directly cause familial hypercholesterolemia, hypertension and hypercholesterolemia are often comorbid conditions that contribute to cardiovascular risk. Both conditions can lead to atherosclerosis, increasing the risk of heart disease and stroke.
F. Isolated systolic hypertension refers to elevated systolic blood pressure with normal diastolic blood pressure. While isolated systolic hypertension itself is a manifestation of hypertension, it is not a direct result of end-organ damage. However, if left untreated, isolated systolic hypertension can lead to complications such as stroke, heart failure, and kidney disease, which are consequences of end-organ damage from chronic hypertension.
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