Dysrhythmias

Question 1

A patient has a diagnosis of acute myocardial infarction, and his cardiac rhythm is sinus bradycardia with six to eight premature ventricular contractions (PVCs) per minute. The pattern that the nurse recognizes as the most characteristic of PVCs is which of the following?

1. An irregular rhythm
2. An inverted T wave
3. A wide, distorted QRS complex
4. An increasingly long PR interval

Answer 1

ANS: 3

Premature ventricular contractions have wide and distorted QRS complexes.

Question 2

A patient in the coronary care unit develops ventricular fibrillation. Which of the following actions should the nurse take first?

1. Perform defibrillation.
2. Initiate cardiopulmonary resuscitation.
3. Prepare for synchronized cardioversion.
4. Administer IV antidysrhythmic medications per protocol.

Answer 2

ANS: 2

Immediate treatment for ventricular fibrillation is the initiation of cardiopulmonary resuscitation, followed by the use of defibrillation and definitive medication therapy according to advanced cardiac life support guidelines.

(think CAB)

Question 3

A patient’s cardiac rhythm is sinus bradycardia with a heart rate of 34 beats/minute. If the bradycardia is symptomatic, which of the following findings should the nurse expect the patient to exhibit?

1. Palpitations
2. Hypertension
3. Warm, flushed skin
4. Shortness of breath

Answer 3

ANS: 4

Signs of symptomatic bradycardia include pale, cool skin; hypotension; weakness; angina; dizziness or syncope; confusion or disorientation; and shortness of breath.