The nurse is reviewing an electrocardiogram rhythm strip. The P waves and QRS complexes are regular. The PR interval is 0.16 seconds, and the QRS complexes measure 0.06 seconds. The overall heart rate is 64 beats/minute. Which would be a correct interpretation based on these characteristics?
Sinus bradycardia
Sinus arrhythmia
Sinus tachycardia
Normal sinus rhythm
The Correct Answer is D
A. Sinus bradycardia: Sinus bradycardia is characterized by a regular rhythm with a heart rate less than 60 beats per minute. In this case, the heart rate is 64 beats per minute, which falls within the normal range, not consistent with sinus bradycardia.
B. Sinus arrhythmia: Sinus arrhythmia typically presents as a variation in the R-R interval with respiration, often seen as an irregularity in the heart rate. The provided characteristics describe a regular rhythm, so sinus arrhythmia is not the correct interpretation.
C. Sinus tachycardia: Sinus tachycardia is characterized by a regular rhythm with a heart rate greater than 100 beats per minute. The heart rate in this case is 64 beats per minute, which is not indicative of sinus tachycardia.
D. Normal sinus rhythm: Normal sinus rhythm refers to a regular rhythm with a heart rate between 60 and 100 beats per minute, P waves preceding each QRS complex, a normal PR interval (0.12 to 0.20 seconds), and normal QRS complex duration (less than 0.12 seconds). The provided characteristics, including regular P waves, regular QRS complexes, a PR interval of 0.16 seconds, and a heart rate of 64 beats per minute, align with a normal sinus rhythm interpretation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Notify the blood bank of the discrepancy:
This choice suggests that there is a discrepancy between the blood type of the unit on hand (type B) and the client's blood type (type AB). However, in reality, there is no discrepancy in this case because individuals with type AB blood are universal recipients and can receive blood from donors of any blood type, including type B. Therefore, there is no need to notify the blood bank of any discrepancy.
B. Administer the blood as ordered:
This choice is the correct action. Type AB individuals are known as universal recipients because they can safely receive blood from donors of any blood type (A, B, AB, or O) without causing a major transfusion reaction. Since the client has type AB blood and the unit of blood on hand is type B, the nurse can administer the blood as ordered without concerns about blood type compatibility.
C. Complete an incident report:
Completing an incident report is typically done when an unexpected event or error occurs during patient care. In this scenario, there is no error or unexpected event related to blood type compatibility, so there is no need to complete an incident report.
D. Contact the provider for further orders:
Contacting the provider for further orders would be necessary if there were a specific reason or concern related to the blood transfusion that requires clarification or additional instructions. However, in this case, there are no issues with blood type compatibility, so contacting the provider is not necessary.
Correct Answer is D
Explanation
A. Increasing fluids to maintain BP: While staying well-hydrated is generally beneficial for overall health and blood pressure management, increasing fluids is not the primary intervention for dizziness associated with alpha-adrenergic blockers. Alpha-blockers can cause orthostatic hypotension, which may lead to dizziness upon standing, especially if rising quickly.
B. Taking medication first thing in the morning: Taking medication in the morning is a common recommendation for many medications, including some antihypertensive drugs. However, for alpha-adrenergic blockers that can cause orthostatic hypotension, timing of medication administration is not the primary concern in addressing dizziness.
C. Stopping medication if dizziness persists: Abruptly stopping medication without consulting a healthcare provider is not recommended, especially for antihypertensive medications. It's important for clients to follow their prescribed treatment plan and communicate any side effects or concerns to their healthcare provider for appropriate management.
D. Rising slowly from a lying or sitting position: This is the correct emphasis for the nurse. Alpha-adrenergic blockers can cause orthostatic hypotension, a drop in blood pressure upon standing, which can lead to dizziness or lightheadedness. To minimize this risk, the client should be advised to rise slowly from lying down or sitting to standing positions. This gradual movement helps the body adjust to changes in blood pressure more effectively.
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