A nurse is caring for a client in the emergency department (ED).

Exhibits
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Answer and Explanation

The Correct Answer is []

AF is characterized by irregular, rapid heartbeat (100 to 175 beats per minute (bpm) and the absence of distinct P waves.

Management of unstable atrial fibrillation include immediate pharmacological or electrical cardioversion and anticoagulation.

Atrial fibrillation leads to ineffective pumping and stasis of blood in the heart which increases the risk of stroke.

On initiating anticoagulation, PTT/INR is important to ensure that the drug is administered at doses that achieve the optimal therapeutic effect.

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Correct Answer is D

Explanation

D. Assessing the patient's level of consciousness (LOC) is essential to determine their neurological status and assess for any signs of deterioration. Changes in LOC could indicate worsening sepsis, hypoperfusion, or other underlying issues that require immediate attention.

A. Administering amiodarone, an antiarrhythmic medication, is not the first action to take in this situation. While amiodarone may be used to manage certain arrhythmias, its use should be based on a thorough assessment and specific arrhythmia diagnosis. In this case, with only three seconds of PVCs followed by sinus tachycardia, immediate administration of amiodarone is not warranted.

B. Carotid massage is not indicated in this scenario. Carotid massage is typically used to slow down or terminate supraventricular tachycardias (SVTs), such as paroxysmal supraventricular tachycardia (PSVT). However, it is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), carotid artery disease, or recent myocardial infarction (MI). Furthermore, PVCs are not typically responsive to carotid massage.

C. Administering Tylenol (acetaminophen) may be appropriate in this situation. The patient's elevated temperature (101.1°F) suggests the presence of fever, which could contribute to the patient's tachycardia. Lowering the fever with acetaminophen may help reduce the heart rate and alleviate symptoms associated with fever, such as discomfort.

A. Different blood pressures in the upper limbs. B. Differences in upper and lower lung sounds. C. Differences between oral and axillary temperatures. D. Different apical and radial pulses.

Correct Answer is D

Explanation

D. Atrial fibrillation can lead to irregular and often rapid heart rates, resulting in discrepancies between the apical (heart) and radial (peripheral) pulses. In atrial fibrillation, the atria fibrillate instead of contracting effectively, leading to irregular and sometimes asynchronous ventricular contractions. This irregularity may result in a pulse deficit, where the number of apical beats exceeds the number of radial pulses felt at the wrist.

A. Different blood pressures in the upper limbs may indicate conditions such as aortic dissection or arterial stenosis, but they are not typically associated with atrial fibrillation. Atrial fibrillation primarily affects the heart rhythm rather than blood pressure distribution.

B. Differences in upper and lower lung sounds may indicate conditions such as pneumonia or pleural effusion, but they are not specific to atrial fibrillation. Atrial fibrillation primarily affects the heart's electrical activity rather than respiratory findings.

C. Differences between oral and axillary temperatures may indicate localized variations in temperature, such as infection or inflammation, but they are not specific to atrial fibrillation. Atrial fibrillation primarily affects cardiac rhythm rather than body temperature regulation.

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Naxlex Comprehensive Predictor Exams

A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate ie 116/ min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?

Correct Answer is D

Explanation

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

Correct Answer is D

Explanation

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