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Nursing III Cardiac 3 Exam > Chapter 25 > Flashcards

Chapter 25 Flashcards

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1
Q

Size or fullness of voltage

A

Amplitude

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2
Q

Electrical activation of the atria

A

Atrial depolarization

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3
Q

Contraction of the two ventricles

A

Ventricular systole

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4
Q

Originating from many foci or sites

A

Multifocal

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5
Q

Occurs every second beat, as in PVCs

A

Bigeminy

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6
Q

Coming or originating from one site

A

Unifocal

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7
Q

Belonging to anything naturally

A

Inherent

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8
Q

Local deficiency of blood supply resulting from obstruction of the circulation to another part

A

Ischemia

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9
Q

Period of relaxation of the ventricle

A

Ventricular diastole

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10
Q

Use of electrical device to apply countershocks to the heart through electrodes placed on the chest wall to stop fibrillation

A

Defibrillate

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11
Q

Electrical tracing is at zero and is neither positive nor negative

A

Isoelectric line

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12
Q

Failure of the heart to maintain adequate circulation

A

Decompensation

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13
Q

Condition in which there is a complete dissociation between atrial and ventricular systoles

A

Complete heart block

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14
Q

Contraction of the atria

A

Atrial systole

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15
Q

Force with which left ventricular ejection occurs

A

Contractility

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16
Q

Occurring every third beat, as in PVCs

A

Trigeminy

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17
Q

Defect in heart conduction system in which right bundle does not conduct impulses normally

A

Right bundle branch block

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18
Q

Elective procedure in which synchronized shock of 25 to 50 joules is delivered to restore normal sinus rhythm

A

Cardioversion

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19
Q

Reestablishment of the polarized state of the muscle after contraction

A

Ventricular repolarization

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20
Q

Naturally occurring rhythm of the ventricles when the rest of the conduction system fails

A

Ventricular escape rhythm

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21
Q

Beat occurring every fourth complex as in premature ventricular contractions (PVCs)

A

Quadrigeminy

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22
Q

Rate no less than 60

A

bradycardia

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23
Q

An early beat

A

Premature

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24
Q

Chamber of the heart that propels blood into the pulmonary artery

A

Right ventricle

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25
Q

A chaotic pattern - no visible cardiac cycles

A

Ventricular fibrillation

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26
Q

The wave that follows the QRS complex

A

T wave

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27
Q

A small wave seen after the T wave

A

U wave

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28
Q

The first positive deflection on a QRS complex

A

R wave

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29
Q

The chamber of the heart that pumps the blood to the rest of the body

A

Left ventricle

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30
Q

The downward deflection after the R wave

A

S wave

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31
Q

Heart rate of more than 100 beats per minute

A

Tachycardia

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32
Q

An early beat with no P wave and a wide, bizarre QRS complex

A

Premature ventricular contraction

33
Q

No QRS complexes seen - straight line

A

Asystole

34
Q

Where normal cardiac impulse originates

A

Sinoatrial node

35
Q

Successive beats of three or more wide, bizarre QRS complexes

A

Ventricular tachycardia

36
Q

The first negative deflection of a QRS complex

A

Q wave

37
Q

Wave that proceeds a QRS complex

A

P wave

38
Q

Where an impulse is delayed before going to the Purkinje fibers

A

Atrioventricular node

39
Q

An early beat that has a P wave and a normal QRS complex

A

Premature atrial contraction

40
Q

No identifiable P waves with a normal QRS complex: irregularly irregular

A

Atrial fibrillation

41
Q

Rhythm with normal P waves, QRS, T waves with a heart rate of 60 to 100 beats per minute

A

Normal sinus rhythm

42
Q

The chamber of the heart that receives blood from the pulmonary veins

A

Left atrium

43
Q

Rhythm with normal P waves, QRS, T waves with a heart rate of more than 100 beats per minute

A

Sinus tachycardia

44
Q

Chamber of the heart that receives blood returning to the heart

A

Right atrium

45
Q

Rhythm with normal P waves, QRS, T waves with a heart rate of less than 60 beats per minute

A

Sinus bradycardia

46
Q

The nurse understands that which of the following defines a cardiac cycle?

a) Circulation of the blood through the body
b) Circulation of the blood through the heart
c) Depolarization and repolarization of heart chambers
d) Pumping action of the heart

A

c) Depolarization and repolarization of heart chambers

47
Q

The heart receives blood returning from the body through which of the following?

a) Pulmonary vein
b) Aorta
c) Vena cavae
d) Right coronary artery

A

c) Vena cavae

48
Q

Which of the following separates the right side of the heart from the left?

a) Chamber
b) Pericardium
c) Valve
d) Septum

A

d) Septum

49
Q

Which of the following chambers of the heart is the largest and has the thickest myocardium?

a) Left ventricle
b) Right ventricle
c) Right atrium
d) Left atrium

A

a) Left ventricle

50
Q

Which of the following waveforms represents the resting state of the ventricle on the ECG?

a) P wave
b) QRS complex
c) U wave
d) T wave

A

d) T wave

51
Q

Which of the following is the inherent rate for the atrioventricular node?

a) 20 to 40 bpm
b) 40 to 60 bpm
c) 60 to 100 bpm
d) more than 100 bpm

A

b) 40 to 60 bpm

52
Q

The nurse understands that rhythms arising from the primary pacing node of the heart are referred to as which of the following?

a) Escape beats
b) Bundle branch blocks
c) Sinus rhythms
d) Ectopic rhythms

A

c) Sinus rhythms

53
Q

The nurse notes a life-threatening dysrhythmia on a patient’s cardiac monitor. Which of the following is the nurse’s first appropriate action?

a) Notify the physician immediately
b) Assess the patient
c) Administer the appropriate medication for the noted dysrhythmia
d) Obtain vital signs

A

b) Assess the patient

54
Q

The nurse is teaching a patient about digoxin. Which of the following should the nurse include in the teaching?

a) Digoxin decreases ectopic beats
b) The force of contractions is increased with digoxin
c) The resting heart rate increases when digoxin is taken
d) Digoxin raises the resting blood pressure

A

b) The force of contractions is increased with digoxin

55
Q

The nurse is providing care to a patient with atrial fibrillation. Which of the following statements, if made by the patient, would be of the most concern?

a) Aspirin upsets my stomach, so I quit taking it
b) IT seems like my feet are a little swollen
c) My wife and I got a membership at the local health club
d) Ive been having trouble falling asleep at night

A

a) Aspirin upsets my stomach, so I quit taking it

56
Q

Which of the following treatments is appropriate for a patient with atrial fibrillation? (Select all that apply)

a) Amiodarone (Cordarone)
b) Nitroglycerin
c) Warfarin (Coumadin)
d) Digoxin (Lanoxin)
e) Cardioversion
f) Epinephrine

A

a) Amiodarone (Cordarone)
c) Warfarin (Coumadin)
d) Digoxin (Lanoxin)
e) Cardioversion

57
Q

The nurse is caring for a patient who has had a run of three or more PVCs together. The nurse should document this as which of the following?

a) Ventricular tachycardia
b) Bigeminy
c) Trigeminy
d) Multifocal PVCs

A

a) Ventricular tachycardia

58
Q

The nurse is caring for a patient in ventricular tachycardia who is hemodynamically stable. Which of the following is the initial treatment for this dysrhythmia?

a) Cardioversion
b) Pacemaker
c) Defibrillation
d) Antiarrhythmic intravenous medication

A

d) Antiarrhythmic intravenous medication

59
Q

The nurse is caring for a patient whose ECG monitor shows a total absence of electrical impulse. The nurse does not detect a pulse. The nurse documents this as which of the following rhythms?

a) Agonal
b) Asystole
c) Sinus arrest
d) Ventricular standstill

A

b) Asystole

60
Q

A patient with a cardiac disorder is having increased PVCs and feels “anxious”. After assessment and vital signs, what is the next action for the nurse to take?

a) Order an ECG and cardiac enzymes
b) Call the physician
c) Elevate the head of the bed and start oxygen at 2 L/min
d) Put the bed in modified Trendelenburg’s position

A

c) Elevate the head of the bed and start oxygen at 2 L/min

61
Q

For which of the following dysrhythmias will the nurse anticipate a patient’s need for a permanent pacemaker? (Select all that apply)

a) Ventricular fibrillation
b) First-degree heart block
c) Atrial fibrillation
d) Third-degree heart block
e) Symptomatic bradycardia
f) Premature atrial contractions (PACs)

A

d) Third-degree heart block

e) Symptomatic bradycardia

62
Q

Increases clotting time. Reduces risk of blood clots in atrial fibrillation
Example - warfarin (Coumadin)

A

Anticoagulant

63
Q

Inhibit ventricular dysrhythmias, atrial fibrillation, atrial flutter.
Example - amiodarone (Cordarone, Pacerone)
Inhibits atrial fibrillation, atrial flutter
Example - dronedarone (Multaq)

A

Antidysrhythmics

64
Q

Increases heart rate. Treats symptomatic bradycardia, asystole
Example - atropine

A

Anticholinergic

65
Q

Decrease myocardial contractility
Example - atenolol (Tenormin)
Controls rate in sinus tachycardia, PAC, atrial flutter, atrial fibrillation, PVC
Example - metoprolol succinate (Lopressor, Toprol XL)

A

Beta blockers

66
Q

Decreases myocardial contractility and depresses conduction system
Controls rate in sinus tachycardia, atrial flutter, and atrial fibrillation
Example - amlodipine (Norvasc)

A

Calcium channel blocker

67
Q

Slows heart rate
Maintains sinus rhythm for sinus tachycardia, atrial flutter, atrial fibrillation
Example - digoxin (Lanoxicaps, Lanoxin)

A

Inotrope - Cardiac glycoside (Positive inotrope and negative chronotrope)

68
Q

*Cardiac stimulation, vasoconstriction, bronchodilation
Treats asystole, ventricular tachycardia, ventricular fibrillation, symptomatic bradycardia
Example - epinephrine (Adrenalin)
*Vasoconstricts. Reduces urine volume. Single dose may replace dose of epinephrine.
Treats pulseless ventricular tachycardia, ventricular fibrillation, asystole
Example - vasopressin (Pitressin)
*Increases cardiac output and blood pressure
Treats bradycardia
Example - dopamine

A

Vasopressors

69
Q

What is the most common factor that increases the risk of dysrhythmias in older adults?

A

Digitalis toxicity

70
Q

____ is a lifesaving procedure used for pulseless ventricular tachycardia to ventricular fibrillation. It delivers an electrical shock to reset the heart’s rhythm

A

Defibrillation

71
Q

Patients are placed on a cardiac monitor and rest for several hours after insertion of a _______

A

pacemaker

72
Q

The dressing at the pacemaker insertion site is monitored every __ to __ hours for signs of bleeding

A

2 to 4

73
Q

Place the following in the correct sequence for normal electrical impulse movement through the cardiac conduction system

a) AV node
b) SA node
c) bundle of His
d) Purkinje fibers
e) Internodal tracts

A

b, e, a, c, d

74
Q

Why is it important for the nurse to use a systematic method for analyzing heart rhythm tracing?

a) So abnormalities are not missed
b) To save time
c) To develop a routine for examining tracing
d) To increase memory of the analysis steps

A

a

75
Q

If a patient is in pulseless ventricular tachycardia, which of the following is the first choice of treatment?

a) Synchronized cardioversion
b) Pacemaker
c) Defibrillation
d) Antiarrythmic meds

A

c

76
Q

Which of the following instructions should the nurse give the patient regarding pacemaker care?

a) Avoid microwaves
b) You may have an MRI
c) Take your radial pulse daily
d) You will need to be on bedrest for 48 hours

A

c

77
Q

The nurse is ambulating a patient who is recovering from an MI when the patient develops chest pain with an irregular pulse. What is the safest way to return the patient to bed?

a) Ambulation to room with one assistant
b) With assistance by gurney
c) With assistance by a wheelchair
d) After completion of ambulation

A

b

78
Q

A patient has a radial pulse of 58 bpm. Which of the following is the appropriate term for documenting this rhythm?

a) Normal
b) Asystole
c) Tachycardia
d) Bradycardia

A

d

79
Q

The nurse is to give a patient amiodarone 800 mg/day PO in 2 divided doses. The nurse has available 200-mg tablets. How many tablets should the nurse give for each dose?

A

2 tablets per dose

Nursing III Cardiac 3 Exam (2 decks)

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