A patient who is a candidate for an implantable cardioverter defibrillator (ICD) asks the nurse about the purpose of this device.
What would be the nurse’s best response?
To detect and treat bradycardia, which is an excessively slow heart rate.
To detect and treat atrial fibrillation, in which your heart beats too quickly and inefficiently.
To detect and treat dysrhythmias such as ventricular fibrillation and ventricular tachycardia.
To shock your heart if you have a heart attack at home.
To shock your heart if you have a heart attack at home.
The Correct Answer is B
Choice A rationale:
Bradycardia refers to a slow heart rate, typically defined as less than 60 beats per minute.
While some ICDs can provide pacing for bradycardia, this is not their primary purpose.
Their primary goal is to prevent sudden cardiac death from life-threatening arrhythmias.
Therefore, Choice A is not the best response.
Choice B rationale:
Atrial fibrillation (AFib) is a common heart rhythm disorder characterized by rapid and irregular beating of the atria.
While ICDs can sometimes be used in patients with AFib, this is not their primary indication.
AFib is typically managed with medications to control heart rate and rhythm, or with ablation procedures to disrupt the abnormal electrical pathways.
Therefore, Choice B is not the best response.
Choice C rationale:
Ventricular fibrillation (VF) and ventricular tachycardia (VT) are life-threatening arrhythmias that originate in the ventricles of the heart.
VF is characterized by chaotic, disorganized electrical activity in the ventricles, leading to ineffective pumping and cardiac arrest.
VT is a very fast heart rhythm that can degenerate into VF.
ICDs are specifically designed to detect and treat VF and VT.
They do this by delivering electrical shocks to the heart, which can restore a normal rhythm.
Therefore, Choice C is the best response.
Choice D rationale:
While ICDs can deliver shocks during a heart attack, this is not their primary purpose.
Heart attacks are caused by a blockage of blood flow to the heart muscle, and they are typically treated with medications, such as aspirin, nitroglycerin, and clot-busting drugs.
ICDs are primarily used to prevent sudden cardiac death from life-threatening arrhythmias, not to treat heart attacks themselves.
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Related Questions
Correct Answer is B
Explanation
Choice B rationale:
It is crucial to ensure that no one is touching the client during defibrillation to prevent accidental electrical shock to others. The electrical current delivered by the defibrillator is extremely powerful and can cause serious injury or even death if it passes through another person's body. This includes both healthcare professionals and bystanders.
Here are key points to emphasize this rationale:
Electrical conduction: The human body is a good conductor of electricity. If someone is touching the client during defibrillation, the electrical current from the defibrillator can easily pass through their body, potentially causing harm.
Cardiac rhythm disruption: Any contact with the client during shock delivery can interfere with the defibrillator's ability to accurately assess the client's heart rhythm and deliver the appropriate shock. This could potentially worsen the client's condition.
Muscle contractions: The electrical current from the defibrillator can cause involuntary muscle contractions. If someone is touching the client, these contractions could cause them to jerk or move suddenly, potentially causing injury to themselves or others.
Safety guidelines: It is a standard safety guideline in all healthcare settings to clear the area around a client before defibrillation to ensure the safety of everyone involved.
I'll now address the other choices, even though they are not the correct answer, to provide a comprehensive understanding:
Choice A rationale:
While ventilation is important during cardiac arrest, it should be temporarily paused during defibrillation. The chest compressions and electrical shock can cause movement of air in the lungs, which can interfere with the effectiveness of the defibrillation. Additionally, the risk of accidental shock to the person providing ventilation is increased if they are close to the client during defibrillation.
Choice C rationale:
Waiting 3 minutes between shocks is not necessary with modern defibrillators. Current guidelines recommend immediate defibrillation for shockable rhythms such as ventricular fibrillation or pulseless ventricular tachycardia. Delaying defibrillation can decrease the chances of successful resuscitation.
Choice D rationale:
The placement of gel pads is important for effective conduction, but it is not the priority action during defibrillation. Ensuring safety by clearing the area and delivering the shock promptly is more critical in the initial moments of defibrillation.
Correct Answer is A
Explanation
Choice A rationale:
Clopidogrel is an antiplatelet medication that is essential for preventing blood clots from forming within coronary artery stents. It works by inhibiting the binding of adenosine diphosphate (ADP) to its receptors on platelets, thereby reducing platelet aggregation. This is crucial following stent placement because the stent itself can act as a trigger for platelet activation and clotting. By suppressing platelet function, clopidogrel helps to maintain blood flow through the stented artery and reduces the risk of stent thrombosis, a potentially life-threatening complication.
Here's a detailed explanation of why the other choices are incorrect:
Choice B: Ibuprofen
Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is primarily used to treat pain and inflammation.
It does not have significant antiplatelet effects and is not typically used for the prevention of stent thrombosis.
While it might be prescribed for pain management after stent placement, it would not be the primary medication expected on the daily medication administration record for this purpose.
Choice C: Dipyridamole
Dipyridamole is an antiplatelet medication, but it is not as potent as clopidogrel and is not considered the first-line agent for preventing stent thrombosis.
It might be used in combination with clopidogrel in certain cases, but it would not be the sole antiplatelet medication expected on the daily medication administration record.
Choice D: Acetaminophen
Acetaminophen is a pain reliever and fever reducer.
It does not have any antiplatelet effects and would not be used to prevent stent thrombosis.
It might be prescribed for pain or fever after stent placement, but it would not be the primary medication expected on the daily medication administration record for this purpose.
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