A cardiac pacemaker might be indicated in all of the following except:
sinus arrhythmia
post cardiac surgery
third-degree AV block
bradyarrhythmias
The Correct Answer is A
A. sinus arrhythmia: Sinus arrhythmia is a normal variation in heart rate that occurs with the respiratory cycle, typically seen as a benign increase in heart rate during inspiration and a decrease during expiration. It does not compromise cardiac output or cause symptoms, so a pacemaker is generally not indicated.
B. post cardiac surgery: After cardiac surgery, patients may develop transient conduction disturbances such as heart block or significant bradyarrhythmias. A pacemaker may be indicated if these conduction abnormalities persist and result in hemodynamic instability, as it helps maintain adequate cardiac output during recovery.
C. third-degree AV block: Third-degree atrioventricular (AV) block represents complete dissociation between atrial and ventricular activity, often leading to severe bradycardia and risk of syncope or sudden cardiac arrest. Permanent pacemaker implantation is a primary treatment to restore ventricular pacing and prevent life-threatening complications.
D. bradyarrhythmias: Symptomatic bradyarrhythmias, including sinus node dysfunction or high-grade AV block, can lead to dizziness, syncope, or heart failure due to insufficient cardiac output. Pacemaker therapy provides electrical stimulation to maintain adequate heart rate and improve symptoms, making it a standard indication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Rhythm: sinus, regular
Rate: 38b/min
P wave: Present, normal
PR interval: Prolonged
QRS: Narrow, 0.04 seconds
Rhythm interpretation: Second degree AV block Type I
Correct Answer is A
Explanation
A. Initiate CPR: Pulseless ventricular tachycardia is a life-threatening cardiac arrest rhythm. Immediate initiation of high-quality cardiopulmonary resuscitation (CPR) is the highest priority to maintain circulation and perfusion to vital organs. Early CPR improves the likelihood of return of spontaneous circulation and survival until defibrillation and advanced interventions can be performed.
B. Administer oxygen: While oxygen is important, providing supplemental oxygen does not replace the need for immediate CPR in a pulseless patient. Oxygen delivery becomes effective only if circulation is maintained, which is why CPR takes precedence.
C. Administer an antidysrhythmic agent: Antidysrhythmic drugs such as amiodarone may be used during pulseless V-Tach according to ACLS protocols, but administration is secondary to initiating CPR and defibrillation. Delaying CPR to give medication would reduce chances of survival.
D. Instruct the client to inhale deeply and cough: Cough CPR or the Valsalva maneuver is ineffective in true cardiac arrest. A pulseless, unconscious patient cannot follow commands, and these interventions do not provide circulation or address the life-threatening arrhythmia.
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