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 ["B","C"]
Explanation
B. stroke volume is the amount of blood ejected from the left ventricle with each contraction (systole) of the heart. Changes in stroke volume directly affect cardiac output. An increase in stroke volume leads to an increase in cardiac output, while a decrease in stroke volume results in a decrease in cardiac output. Factors that can affect stroke volume include preload, afterload, and contractility of the heart.
C. Heart rate refers to the number of heartbeats per minute. Heart rate directly affects cardiac output by determining how frequently the heart contracts and pumps blood. An increase in heart rate (tachycardia) leads to an increase in cardiac output, while a decrease in heart rate (bradycardia) results in a decrease in cardiac output. Factors such as sympathetic and parasympathetic nervous system activity, hormones, and medications can influence heart rate.
A. Respiratory rate does not directly affect stroke volume or heart rate but changes in respiratory rate can indirectly impact cardiac output through their effects on venous return and preload.
D. Blood pressure represents the force exerted by the blood against the walls of the arteries. While blood pressure does not directly affect cardiac output, it is influenced by cardiac output and systemic vascular resistance (SVR).
Correct Answer is B
Explanation
B. Administering furosemide, a loop diuretic, to a patient in septic shock with low urine output could exacerbate hypovolemia and worsen organ perfusion. It could further reduce preload, exacerbating hypotension, and impairing cardiac output. Loop diuretics are typically contraindicated in hypovolemic shock.
A. Corticosteroids such as hydrocortisone can help improve vascular tone and responsiveness to vasopressors. Given the patient's clinical presentation and lack of response to initial fluid resuscitation, administering hydrocortisone is appropriate.
C. Increasing the fluid infusion rate can help restore intravascular volume and improve organ perfusion. However, caution should be exercised to avoid fluid overload and pulmonary edema.
D .Norepinephrine is a vasopressor commonly used to increase systemic vascular resistance and improve blood pressure in septic shock. It helps maintain perfusion pressure to vital organs, thereby supporting organ function.
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