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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Gonorrhea and chlamydia often coexist in individuals, and doxycycline is prescribed to treat chlamydia in addition to ceftriaxone for gonorrhea. Treating both infections is crucial to reduce the risk of complications and reinfection.
B. While ceftriaxone is effective against N. gonorrhoeae, doxycycline is used to treat chlamydia, not to eradicate resistant strains of gonorrhea.
C. Reinfection during treatment can be minimized with both medications, but the primary purpose of doxycycline is to treat a possible co-infection with chlamydia.
D. This combination therapy does not primarily aim to prevent the development of resistant organisms but to treat both infections effectively.
Correct Answer is B
Explanation
A. S1: S1 is the first heart sound, heard at the beginning of systole, and is not related to diastolic dysfunction.
B. S4: This is the correct answer. An S4 sound is heard late in diastole, often due to increased resistance to filling during diastole, which is typical in diastolic dysfunction.
C. S3: An S3 is a low-pitched sound heard early in diastole, typically associated with systolic dysfunction or heart failure with reduced ejection fraction.
D. S2: S2 is the second heart sound, heard during the end of systole and is not associated with diastolic dysfunction.
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