The nurse is caring for a client with a history of heart failure and notes a new onset of the following rhythm on the client's telemetry monitor. Which action would the nurse take first?

Administer the prescribed daily dose of metoprolol

Obtain the client's blood pressure and pulse

Notify the health care provider about the rhythm

Print a rhythm strip to document the changes in the health record

Answer and Explanation

The Correct Answer is B

B. Assessing the client's vital signs, including blood pressure and pulse, provides critical information about the client's hemodynamic status and response to the new rhythm. Atrial fibrillation can lead to rapid, irregular heart rates and hemodynamic instability, so obtaining vital signs promptly helps the nurse determine the severity of the situation and whether immediate intervention is needed.

A. This action is not the priority when the nurse observes a new onset of atrial fibrillation. While beta- blockers such as metoprolol may be part of the client's long-term management for heart failure and atrial fibrillation, initiating medication administration without further assessment could delay appropriate intervention for the acute change in rhythm.

C. While it is important to communicate changes in the client's condition to the healthcare provider, this action should occur after the nurse has assessed the client's vital signs and determined the urgency of the situation. If the client is stable and responsive to initial interventions, the nurse can then contact the healthcare provider to discuss the new onset of atrial fibrillation and collaborate on further management.

D. Documenting the changes in the client's rhythm is important for continuity of care and communication among healthcare team members. However, obtaining a rhythm strip should not be the first action when a new onset of atrial fibrillation is observed. Assessing the client's vital signs and initiating appropriate interventions to address any hemodynamic instability take precedence.

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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).

A. Cardiac disease B. Renal insufficiency C. Stroke D. Familial hypercholesterolemia E. Atrial fibrillation F. Isolated systolic hypertension

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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The nurse is caring for a client with a history of heart failure and notes a new onset of the following rhythm on the client's telemetry monitor. Which action would the nurse take first?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following factors can directly affect cardiac output?

Correct Answer is ["B","C"]

Explanation

Which is(are) potential result(s) of end-organ damage from chronic hypertension? (Select all that apply.)

Correct Answer is ["A","B","C","E"]

Explanation

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