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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
While it is generally recommended to avoid close or prolonged exposure to strong magnetic fields, such as those generated by MRI machines, placing items that generate magnetic fields over the pacemaker/ICD, such as cell phones or certain medical devices, does not typically pose a risk. Therefore, it would be important for the nurse to clarify the client's understanding and provide accurate information about the precautions related to magnetic fields.
The other statements made by the client are generally correct and align with the typical recommendations for individuals with pacemakers/ICDs:
Avoiding contact sports or lifting heavy objects for a specified period of time after pacemaker/ICD insertion is usually advised to allow for proper healing and to reduce the risk of lead dislodgment or damage to the device.
Informing dentists and healthcare providers about the presence of a pacemaker/ICD is important so that they can take appropriate precautions during procedures or treatments that may involve electromagnetic interference or interfere with the device's functioning.
While it is generally advised to avoid close proximity to strong magnetic fields, such as those in airports or certain household appliances, it does not necessarily mean completely avoiding them. The nurse can clarify the specific recommendations regarding metal detectors at airports and the safe use of household appliances.
Correct Answer is B
Explanation
The most appropriate intervention for a client diagnosed with peripheral arterial insufficiency is: Encourage the client to engage in a moderate amount of exercise. Peripheral arterial insufficiency is a condition characterized by reduced blood flow to the extremities, typically the legs, due to narrowed or blocked arteries. Regular exercise is an important component of managing peripheral arterial insufficiency. Exercise helps improve circulation, promote collateral blood vessel development, and increase the distance a client can walk before experiencing pain (intermittent claudication). Therefore, encouraging the client to engage in a moderate amount of exercise, such as walking, under healthcare provider guidance is crucial.]

The other options are not appropriate interventions for peripheral arterial insufficiency:
Elevating the legs and arms above the heart when resting: While elevation can be beneficial for certain conditions, such as reducing swelling in venous insufficiency, it is not the primary intervention for peripheral arterial insufficiency. Elevation alone does not improve arterial blood flow and may not effectively address the underlying circulatory issues.
Encouraging extended periods of sitting or standing: Prolonged sitting or standing can further restrict blood flow and exacerbate symptoms in clients with peripheral arterial insufficiency. Encouraging regular movement and avoiding prolonged immobility is important to maintain adequate circulation.
Discouraging walking in order to limit pain: While walking may cause pain or discomfort in clients with peripheral arterial insufficiency (intermittent claudication), it is important to encourage walking as part of an exercise regimen. Walking helps improve symptoms over time and promotes overall cardiovascular health.
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