A nurse supervises an assistive personnel (AP) applying electrocardiographic monitoring. Which statement would the nurse provide to the AP related to this procedure?

"Clean the skin and clip hairs if needed."

"Turn off oxygen prior to monitoring the client."

"Place the electrodes on the posterior chest."

"Add gel to the electrodes prior to applying them."

Answer and Explanation

The Correct Answer is A

A. Cleaning the skin and clipping hairs ensures good electrode contact, which is essential for accurate ECG readings. This is the correct statement.

B. Oxygen should not be turned off unless specifically instructed by a provider. It does not interfere with ECG monitoring.

C. Electrodes should be placed on the anterior chest for standard ECG monitoring, not on the posterior chest.

D. Electrodes for ECG monitoring typically come with adhesive backing and do not require additional gel.

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Correct Answer is B

Explanation

A. Orthopnea: Orthopnea is difficulty breathing when lying flat, but the client's description of waking up suddenly points to paroxysmal nocturnal dyspnea.

B. Paroxysmal nocturnal dyspnea: This is the correct answer. Paroxysmal nocturnal dyspnea occurs when a client with heart failure wakes up at night feeling suffocated due to fluid redistribution and pulmonary congestion.

C. Pulsus alternans: Pulsus alternans refers to alternating strong and weak heartbeats and is not related to the client's description of nocturnal dyspnea.

D. Acute bilateral pleural effusion: While pleural effusion can cause respiratory symptoms, paroxysmal nocturnal dyspnea is more specific to heart failure.

A. Test the equipment by delivering a smaller shock at 50 J. B. Administer 2 mg of intravenous epinephrine. C. Make sure that the defibrillator is set to the synchronous mode. D. Ensure that everyone is clear of contact with the client and the bed.

Correct Answer is D

Explanation

A. Testing the equipment with a smaller shock is unnecessary when preparing to defibrillate in an emergency.

B. Epinephrine is used in cases of cardiac arrest with no pulse, particularly in asystole or pulseless electrical activity (PEA), not immediately before defibrillation in ventricular fibrillation.

C. Synchronous mode is used for cardioversion, not for defibrillation. Defibrillation should be delivered in unsynchronized mode.

D. Before delivering a shock, it is essential to ensure that everyone, including the nurse, is clear of the client and any conductive surfaces like the bed. This prevents injury from the electrical shock.

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A nurse supervises an assistive personnel (AP) applying electrocardiographic monitoring. Which statement would the nurse provide to the AP related to this procedure?

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