The nurse identifies the following rhythm on the cardiac monitor. Which treatment modality will the nurse anticipate for this client?
Radiofrequency ablation
Administration of amiodarone
insertion of a pacemaker
Administration of adenosine
The Correct Answer is C
A. Radiofrequency ablation: This is used to treat tachyarrhythmias such as atrial fibrillation, atrial flutter, or supraventricular tachycardia (SVT). The ECG shown does not demonstrate any tachycardic rhythm rather, it shows a bradyarrhythmia with dropped QRS complexes, which suggests a conduction block, not a reentrant circuit.
B. Administration of amiodarone: Amiodarone is primarily used for ventricular arrhythmias or atrial fibrillation. It is not effective in treating bradyarrhythmias or heart blocks such as those seen in this rhythm strip.
C. Insertion of a pacemaker: The rhythm strip shows intermittent dropped QRS complexes with consistent P waves—this is indicative of second-degree AV block, Mobitz II. This type of conduction block can progress to complete heart block and is often treated with the insertion of a permanent pacemaker to maintain cardiac output.
D. Administration of adenosine: Adenosine is used to terminate SVT by temporarily blocking AV node conduction. It is contraindicated in heart blocks, especially Mobitz II or third-degree AV block, because it can worsen the block and cause asystole.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Edema of ankles: While peripheral edema may be associated with worsening cardiac function or side effects from other medications, it is not a hallmark adverse effect of amiodarone. It warrants evaluation but is not the most urgent symptom related to this drug.
B. Shortness of breath: Amiodarone is a potent antiarrhythmic medication with several potential serious side effects, including pulmonary toxicity. This can manifest as interstitial pneumonitis or pulmonary fibrosis, which may present as new or worsening shortness of breath cough, and chest pain. This is a potentially life-threatening complication and requires immediate medical attention.
C. Fatigue after exercise: Exercise-induced fatigue can result from many conditions, including heart disease or deconditioning, but it is a nonspecific symptom. It does not point directly to a serious adverse reaction from amiodarone.
D. Abdominal fullness: Abdominal fullness is not typically associated with amiodarone. It may relate to gastrointestinal or hepatic issues, but it is not as immediately concerning as respiratory symptoms suggestive of pulmonary toxicity.
Correct Answer is A
Explanation
A. Ensure all tubing connections are tightened: Tight tubing connections are critical in preventing accidental disconnection, which can result in rapid blood loss and air embolism. Arterial lines are under high pressure, so securing all connections is a top priority to ensure patient safety and maintain line integrity.
B. Apply a pressure dressing to the insertion site: A transparent occlusive dressing not a pressure dressing is used for arterial lines to allow for site visualization and reduce the risk of infection. A pressure dressing could obscure signs of bleeding or compromise the catheter’s position.
C. Perform an Allen's test: Allen’s test is performed prior to radial arterial line insertion to assess collateral circulation via the ulnar artery for preventing ischemic complications if the radial artery is compromised. Performing the test afterward does not prevent complications and is no longer relevant once the catheter is placed.
D. Obtain a portable x-ray to confirm placement: X-rays are used to confirm the placement of central lines, not peripheral arterial lines like the radial line. Arterial line placement is confirmed by waveform analysis and blood return, not imaging.
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