The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?

Obtain consent for transesophageal echocardiogram (TEE)

Obtain consent for a STAT defibrillation

Obtain consent for cardioversion.

Hold digoxin 48 hours prior to cardioversion.

Answer and Explanation

The Correct Answer is B

Defibrillation is not the first-line treatment for atrial fibrillation. It is used to treat life-threatening cardiac arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. Atrial fibrillation, on the other hand, is a rapid and irregular atrial rhythm, and defibrillation is not indicated for its treatment.

Obtain consent for transesophageal echocardiogram (TEE): This is an appropriate action for a client with atrial fibrillation. A TEE is often performed to assess the structure and function of the heart in cases of atrial fibrillation, especially when considering cardioversion or other interventions.

Obtain consent for cardioversion: Cardioversion is a common treatment option for atrial fibrillation, especially when the client is unstable or experiencing symptoms. It involves restoring a normal heart rhythm through the use of electrical shocks or medications. It is important to obtain informed consent before performing cardioversion, but this does not necessarily require questioning.

Hold digoxin 48 hours prior to cardioversion: Digoxin is commonly held before cardioversion because it can increase the risk of certain arrhythmias during the procedure. This is a standard precaution to minimize potential adverse effects. Therefore, the nurse does not need to question this action, as it aligns with established guidelines.

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Correct Answer is C

Explanation

"I will use a heating pad on my feet at night to increase the circulation.": Using a heating pad on the feet at night is not recommended for clients with peripheral artery disease. The application of heat, such as from a heating pad, can dilate blood vessels and potentially worsen the symptoms of peripheral artery disease. This can lead to reduced blood flow to the affected limbs and increase the risk of complications.

The other client statements demonstrate an understanding of peripheral artery disease management:

"I will avoid long periods of sitting down with my legs crossed over." This statement shows awareness of the importance of maintaining good blood flow and avoiding positions that can restrict circulation.

"I will walk to the point of pain, rest, and walk again for at least 30 minutes." This statement indicates an understanding of the concept of intermittent claudication, a common symptom of peripheral artery disease. Walking until pain occurs, resting, and then resuming walking helps improve circulation and increases walking distance over time.

"I will buy some loose clothes that do not bind across my legs or waist." This statement reflects an awareness of the need to wear loose-fitting clothes that do not constrict blood flow to the legs or waist area.

A. Checking the client's catheter site after a coronary angiogram B. Teaching a patient about exercise electrocardiography C. Attaching ECG monitoring electrodes after a patient bathes D. Monitoring a client after a transesophageal echocardiogram

Correct Answer is D

Explanation

Monitoring a client after a transesophageal echocardiogram involves observing the client for any immediate post-procedure complications or adverse reactions. This may include assessing vital signs, monitoring for signs of bleeding or infection, and reporting any concerning symptoms or changes in the client's condition to the nurse.

Checking the client's catheter site after a coronary angiogram requires assessing the site for bleeding, hematoma, or signs of infection. This task involves more complex assessment skills and would typically be performed by the nurse.

Teaching a patient about exercise electrocardiography involves providing education on the purpose of the test, the procedure itself, and any preparation or precautions the patient needs to take. This task requires specialized knowledge and is best performed by the nurse who can address the patient's specific questions and concerns.

Attaching ECG monitoring electrodes after a patient bathes requires technical knowledge and skill in properly placing the electrodes and ensuring accurate ECG readings. This task also falls within the scope of the nurse's responsibilities.

Delegation should be based on the UAP's skill set, training, and the complexity of the task. While the UAP can provide valuable support in monitoring a client after a transesophageal echocardiogram, the other tasks mentioned require the expertise and knowledge of a nurse.

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The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is D

Explanation

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