A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

Synchronized electrical cardioversion

Cardiac resynchronization therapy (CRT)

Heart catheterization with percutaneous intervention

Echocardiogram

Answer and Explanation

The Correct Answer is B

A. Synchronized electrical cardioversion: Synchronized electrical cardioversion is a procedure used to restore normal sinus rhythm in patients with certain types of arrhythmias, such as atrial fibrillation or atrial flutter. However, it is not typically indicated for all patients with worsening heart failure and arrhythmias.

B. Cardiac resynchronization therapy (CRT): CRT, also known as biventricular pacing, involves the placement of a specialized pacemaker device to improve the coordination of contractions between the heart's chambers. It is often used in patients with heart failure and arrhythmias to help regulate the rhythm and improve cardiac function.

C. Heart catheterization with percutaneous intervention: Heart catheterization with percutaneous intervention, such as angioplasty or stent placement, is used to treat coronary artery disease by opening narrowed or blocked blood vessels. While coronary artery disease may contribute to heart failure, this procedure specifically targets the coronary arteries rather than arrhythmias.

D. Echocardiogram : An echocardiogram is a diagnostic test that uses sound waves to create images of the heart's structure and function. While an echocardiogram may provide valuable information about the heart's condition in a patient with heart failure and arrhythmias, it is not a procedure used to regulate the rhythm directly.

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Correct Answer is C

Explanation

A. Third spacing: Third spacing refers to the shifting of fluid from the intravascular space into the interstitial space, leading to decreased circulating volume. While third spacing can contribute to hypovolemic shock, it is not specific to obstructive shock.

B. Cardiomyopathy: Cardiomyopathy is a condition characterized by abnormalities in the heart muscle structure and function. While cardiomyopathy can lead to heart failure, it is not directly associated with obstructive shock.

C. Cardiac tamponade: Cardiac tamponade occurs when fluid accumulates in the pericardial sac, compressing the heart and impairing its ability to fill properly. This condition can lead to obstructive shock due to decreased cardiac output. Signs and symptoms include hypotension, muffled heart sounds, distended neck veins, and pulsus paradoxus.

D. Ruptured aneurysm: A ruptured aneurysm can lead to hypovolemic shock due to acute blood loss. While it can cause significant hemodynamic instability, it is not a characteristic diagnosis of obstructive shock.

A. Poor functional ability B. Rebleeding of the injury C. Decreased cerebrospinal fluid D. Use of nimodipine

Correct Answer is B

Explanation

A. Poor functional ability: While poor functional ability may impact the overall prognosis and quality of life for a client with a subarachnoid hemorrhage (SAH), it is not directly associated with a high mortality rate. Functional ability can be improved with rehabilitation and supportive care.

B. Rebleeding of the injury: Rebleeding of the SAH is a significant risk factor associated with a high mortality rate. Rebleeding can lead to increased intracranial pressure, worsening neurological deficits, and even death. Preventing rebleeding is a critical aspect of managing SAH to improve outcomes.

C. Decreased cerebrospinal fluid: Decreased cerebrospinal fluid (CSF) may indicate conditions such as hydrocephalus, which can complicate the management of SAH. However, it is not directly associated with a high mortality rate compared to rebleeding.

D. Use of nimodipine: Nimodipine is a calcium channel blocker commonly used in the management of SAH to prevent cerebral vasospasm, which can lead to ischemia and worsen outcomes. While nimodipine plays a role in improving outcomes by preventing vasospasm, its use is not directly associated with mortality rates.

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A nurse is planning care for a client who has worsening heart failure and is experiencing arrhythmias. Which of the following procedures should the nurse anticipate the client will require to regulate the rhythm?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing care for a client experiencing obstructive shock. Which of the following diagnoses should the nurse expect?

Correct Answer is C

Explanation

The nurse is assisting with planning care for a client who has a subarachnoid hemorrhage (SAH). Which of the following relates to a high mortality rate for a client who has an SAH?

Correct Answer is B

Explanation

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