After exercising, a client is hooked up to a cardiac monitor. The rhythm below is noted. How should the nurse document this rhythm?

Junctional tachycardia

Sinus tachycardia

Atrial flutter

Ventricular fibrillation

Answer and Explanation

The Correct Answer is B

A. Junctional tachycardia: Junctional tachycardia originates from the atrioventricular (AV) node, with a faster rate and usually no visible P waves preceding the QRS complexes.

B. Sinus tachycardia: Sinus tachycardia is characterized by a regular, rapid heart rhythm originating from the sinus node, typically seen after exercise, with identifiable P waves before each QRS complex.

C. Atrial flutter: Atrial flutter presents with a “sawtooth” pattern of P waves, indicating rapid atrial contractions, which is different from sinus tachycardia.

D. Ventricular fibrillation: Ventricular fibrillation is a chaotic and irregular rhythm originating from the ventricles, which is a life-threatening condition.

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Correct Answer is A

Explanation

A. 3% hypertonic saline: In SIADH, the body holds onto too much water, leading to dilutional hyponatremia. Hypertonic saline helps to slowly raise the sodium level and correct the dilution.

B. Normal saline solution: Normal saline (0.9%) would not be effective for SIADH as it is isotonic and would not correct the sodium imbalance.

C. Dextrose 5% in water: This would not be appropriate, as it contains free water and could exacerbate hyponatremia in a client with SIADH.

D. Lactated Ringers: This is an isotonic solution and would not effectively address the dilutional hyponatremia caused by SIADH.

A. Able to localize pain B. Is verbally responsive, but confused C. Moves arms as directed D. Opens eye to deep pain only

Correct Answer is D

Explanation

A. Able to localize pain: A score of 6 is too low for a client to localize pain, which would require higher motor function.

B. Is verbally responsive, but confused: Verbal responsiveness would require a higher score, as a GCS of 6 indicates severe impairment.

C. Moves arms as directed: Following commands is consistent with a higher GCS score.

D. Opens eyes to deep pain only: This response aligns with the minimal responsiveness expected for a GCS score of 6.

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After exercising, a client is hooked up to a cardiac monitor. The rhythm below is noted. How should the nurse document this rhythm?

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