A client who is on the progressive care unit develops atrial flutter, rate 150 with dyspnea, shortness of breath and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Adenosine 6 mg IV push

Immediate cardioversion

Adenosine 12 mg IV push

Amiodarone 150 mg bolus followed by a 24 hour drip

Answer and Explanation

The Correct Answer is B

A. Adenosine 6 mg IV push: Adenosine is used for certain supraventricular tachycardias, but immediate cardioversion is the first priority for a client with atrial flutter and chest pain.

B. Immediate cardioversion: This is the correct answer. Immediate cardioversion is indicated for atrial flutter with signs of hemodynamic instability, such as chest pain and shortness of breath.

C. Adenosine 12 mg IV push: Adenosine may be used after the first dose of 6 mg if the initial dose was ineffective, but cardioversion takes precedence for unstable patients.

D. Amiodarone 150 mg bolus followed by a 24-hour drip: Amiodarone is an antiarrhythmic used for rate control or rhythm conversion but is not the first step for hemodynamically unstable clients with atrial flutter.

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Correct Answer is A

Explanation

A. The best response is to educate the client about the cause of Prinzmetal angina. It occurs due to spasm in the coronary arteries, which is different from the plaque buildup seen in traditional coronary artery disease. This response addresses the client's concern in an accurate and reassuring manner.

B. While healthy eating is important, Prinzmetal angina is not typically caused by cholesterol or plaque buildup. This response could increase the client's anxiety.

C. While acknowledging the client's emotions is important, this response does not address the underlying concern or provide an accurate explanation of Prinzmetal angina.

D. Offering reassurance without providing accurate information about the condition does not help the client understand the cause of their symptoms and could leave them confused or anxious.

A. Encourage the client to sit up at the bedside in a chair and lean forward. B. Have the client rest in bed with the head elevated 15 to 20 degrees. C. Place the client in the Trendelenburg position with pillows behind the head. D. Ask the client to rest in bed in a high- Fowlers position with the knees flexed.

Correct Answer is A

Explanation

A. Sitting up and leaning forward helps improve lung expansion and ventilation, which is beneficial for clients with COPD.

B. Elevating the head is helpful but not as effective as sitting upright for COPD clients who need to improve their ventilation.

C. The Trendelenburg position is not appropriate for improving ventilation in COPD patients.

D. While high-Fowler's may help in some situations, having the knees flexed can restrict the diaphragm and limit breathing capacity.

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A client who is on the progressive care unit develops atrial flutter, rate 150 with dyspnea, shortness of breath and chest pain. Which action that is included in the hospital dysrhythmia protocol should the nurse do first?

Nursing Test Bank

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Correct Answer is A

Explanation

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Correct Answer is A

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