A client in sinus bradycardia, with a heart rate of 45 beats per minute and blood pressure of 82/60 mm Hg, reports dizziness. Which intervention should the nurse anticipate will be prescribed?
Administer digoxin
Continue to monitor the client.
Defibrillate the client.
Prepare for transcutaneous pacing
The Correct Answer is D
A. Digoxin is a medication used primarily to treat heart failure and certain types of arrhythmias, such as atrial fibrillation. It works by increasing the force of heart contractions and slowing the heart rate. However, digoxin is not typically used to treat bradycardia and may actually exacerbate the condition by further slowing the heart rate.
B. While monitoring is an essential part of patient care, it is not sufficient alone in this situation. The client’s heart rate is very low (45 beats per minute) and their blood pressure is low (82/60 mm Hg), which suggests they are symptomatic and potentially unstable.
C. Defibrillation is used to treat life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. It is not used for sinus bradycardia, which is a slow heart rate rather than a rapid, disorganized rhythm requiring electrical shock.
D. Transcutaneous pacing involves applying external pacing pads to the skin to stimulate the heart and increase the heart rate. This is a suitable intervention for symptomatic bradycardia, especially when accompanied by low blood pressure and dizziness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. While immunizations are important for overall health and preventing various infections, they are not directly related to the risk of infective endocarditis. This question is less relevant to identifying specific risk factors for IE. However, it's worth noting that certain vaccines might be recommended for individuals with certain heart conditions, but this does not directly relate to the risk of IE.
B. A family history of endocarditis may be relevant for understanding genetic or inherited predispositions to heart conditions. However, infective endocarditis is more commonly associated with specific activities or medical procedures rather than family history.
C. A history of a heart attack (myocardial infarction) can contribute to heart disease, but it is not a direct risk factor for infective endocarditis. Infective endocarditis is typically related to infections and procedures that introduce bacteria into the bloodstream, rather than a history of heart attack.
D. This is the most relevant question for identifying a risk factor for infective endocarditis. Dental procedures are a well-known risk factor for IE because they can introduce bacteria into the bloodstream, particularly if the procedures cause bleeding.
Correct Answer is A
Explanation
A. Among the four heart valves (aortic, mitral, tricuspid, and pulmonary), the aortic and mitral valves are indeed the most commonly replaced valves. Aortic stenosis and mitral valve regurgitation are frequent indications for valve replacement
B. Aortic stenosis primarily affects the left ventricle, not the right. Aortic stenosis causes an obstruction of blood flow from the left ventricle into the aorta, leading to increased left ventricular systolic pressure and increased afterload (the resistance the heart must overcome to eject blood). The right ventricular systolic pressure is not directly affected by aortic stenosis.
C. Mitral valve insufficiency (or regurgitation) primarily causes problems on the left side of the heart. When the mitral valve does not close properly, blood flows back into the left atrium during systole, increasing left atrial pressure. This can lead to pulmonary congestion and eventually affect the right side of the heart.
D. The tricuspid valve is on the right side of the heart and its inadequate closure (tricuspid regurgitation) affects the right side of the heart, leading to right-sided heart failure and systemic venous congestion. It does not directly cause overload in the left ventricle. Instead, the left ventricle is typically overloaded in conditions affecting the left side of the heart, such as mitral valve regurgitation or aortic stenosis.
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