A client who has undergone an Automatic Implantable Cardioverter Defibrillator (AICD) procedure asks the nurse about the purpose of this device. What is the nurse's best response?
To detect and treat ventricular tachycardia.
To detect and treat bradycardia.
To shock your heart if you have a heart attack at home.
To monitor for normal sinus rhythm.
The Correct Answer is A
A. To detect and treat ventricular tachycardia: An AICD continuously monitors the heart’s rhythm and delivers an electrical shock or antitachycardia pacing when it detects life-threatening ventricular arrhythmias such as ventricular tachycardia or ventricular fibrillation. Its primary function is to prevent sudden cardiac death by restoring a normal rhythm during these events.
B. To detect and treat bradycardia: While some AICDs may have limited pacing capability, their main purpose is not to treat bradycardia. Bradycardia is more appropriately managed with a pacemaker rather than a defibrillating device.
C. To shock your heart if you have a heart attack at home: The AICD does not detect myocardial infarction itself. It responds to arrhythmias associated with sudden cardiac arrest, not the ischemic event of a heart attack, and cannot prevent or treat the infarction.
D. To monitor for normal sinus rhythm: Although the AICD continuously monitors the heart’s rhythm, its primary purpose is therapeutic intervention for dangerous arrhythmias, not passive rhythm monitoring. Monitoring is secondary to its life-saving function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Increased respiratory rate: An increased respiratory rate may indicate persistent heart failure, hypoxia, or worsening pulmonary congestion rather than improvement. Dobutamine is intended to enhance myocardial contractility and improve cardiac output, which should reduce compensatory tachypnea associated with poor perfusion.
B. Decreased blood pressure: Dobutamine is a beta-1 adrenergic agonist that increases myocardial contractility and stroke volume, typically improving cardiac output and supporting blood pressure. A decrease in blood pressure may indicate worsening cardiac function or excessive vasodilation, not effective therapy.
C. Increased urine output: Improved cardiac output enhances renal perfusion, leading to increased glomerular filtration rate and urine production. In clients with cardiomyopathy, low urine output often reflects poor forward flow. An increase in urine output suggests improved tissue perfusion and effective inotropic support.
D. Decreased blood glucose: Dobutamine does not directly lower blood glucose levels. Its primary action is to stimulate beta-1 receptors in the heart to increase contractility and cardiac output. Blood glucose changes are not used as indicators of therapeutic effectiveness for this medication.
Correct Answer is C
Explanation
A. Allow the client to rest quietly: While rest is generally beneficial, the combination of tachycardia and hypotension suggests possible acute complications such as bleeding or cardiogenic shock. Simply allowing the client to rest does not address the underlying cause and could delay life-saving interventions.
B. Document the findings in the chart: Documentation is important for communication and legal purposes, but it is not an immediate intervention. The nurse must first assess the client for potential causes of hemodynamic instability before charting.
C. Assess the client for bleeding: A drop in blood pressure with a compensatory increase in heart rate may indicate hypovolemia from internal or external bleeding, especially if the client has invasive lines or recent procedures. Prompt assessment and intervention are crucial to prevent shock and organ damage.
D. Medicate the client for pain: Pain management is important, but administering analgesics in the context of hypotension and tachycardia could worsen hemodynamic instability. The priority is identifying and treating the underlying cause before giving medications that may further lower blood pressure.
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