Identify the following rhythm:
Atrial Fibrillation
Ventricular tachycardia
Ventricular Fibrillation
Premature Ventricular Contractions
The Correct Answer is C
Atrial fibrillation (AF) is characterized by disorganized electrical activity in the atria, resulting in an irregular and often rapid heart rate.
On an ECG, AF typically presents with absent P waves, irregular R-R intervals, and a rapid ventricular rate (usually >100 beats per minute).
However, the rhythm in the question does not display these characteristic features of AF.
Key features of AF that are absent in the rhythm include:
P waves: AF lacks identifiable P waves, while the rhythm in question may have discernible P waves, although they may be irregular or abnormal.
Regularity: AF is typically irregular, while the rhythm in question is chaotic and without any discernible pattern.
QRS complexes: AF usually has narrow QRS complexes, while the rhythm in question often has wide and bizarre QRS complexes. Choice B rationale:
Ventricular tachycardia (VT) is a rapid heart rhythm originating from the ventricles, with a rate typically exceeding 100 beats per minute.
On an ECG, VT typically presents with wide QRS complexes (>0.12 seconds), a regular or slightly irregular rhythm, and a rate often exceeding 150 beats per minute.
While the rhythm in question is rapid and may have wide QRS complexes, it lacks the regular or slightly irregular pattern often seen in VT.
Key features of VT that distinguish it from the rhythm in question include:
Regularity: VT often has a regular or slightly irregular pattern, while the rhythm in question is chaotic and without any discernible pattern.
QRS morphology: VT typically has monomorphic (uniform) QRS complexes, while the rhythm in question often has polymorphic (varying) QRS complexes.
Choice D rationale:
Premature ventricular contractions (PVCs) are extra heartbeats originating from the ventricles, interrupting the normal heart rhythm.
On an ECG, PVCs appear as early, wide QRS complexes that are often followed by a compensatory pause.
The rhythm in question does not exhibit the characteristic pattern of PVCs, which typically occur as isolated beats or short runs of beats interspersed within a normal rhythm.
Key features of PVCs that are absent in the rhythm include:
Isolation: PVCs typically occur as isolated beats or short runs of beats, while the rhythm in question is sustained and chaotic.
Compensatory pause: PVCs are often followed by a compensatory pause, which is not a feature of the rhythm in question.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
While maintaining anticoagulation is important in atrial fibrillation to prevent blood clots, it is not the main goal of treatment in this specific scenario.
The client's blood pressure is elevated, suggesting that the rapid heart rate is the more immediate concern.
Additionally, the prompt indicates that heparin has already been administered, addressing the anticoagulation need.
Choice B rationale:
The client's respiratory rate and lung sounds are normal, indicating that oxygenation is not a primary concern at this time.
The fast heart rate is the more pressing issue, as it can lead to decreased cardiac output and potential complications.
Choice C rationale:
Controlling the ventricular heart rate is the main goal of treatment in this case.
Atrial fibrillation with a rapid ventricular response can lead to several detrimental consequences, including:
Decreased cardiac output due to shortened ventricular filling time
Increased myocardial oxygen demand, potentially causing angina or heart failure
Increased risk of stroke or other thromboembolic events
Diltiazem, a calcium channel blocker, is a medication commonly used to slow the heart rate in atrial fibrillation.
By slowing the conduction of electrical impulses through the atrioventricular (AV) node, it effectively reduces the number of impulses that reach the ventricles, thereby controlling the ventricular response.
Choice D rationale:
Decreasing SA node conduction is not a primary goal in this situation.
The SA node is responsible for initiating the normal electrical impulses that trigger heart contractions.
In atrial fibrillation, the electrical activity is chaotic and originates from multiple foci within the atria, rather than the SA node.
Therefore, targeting the SA node would not effectively address the underlying rhythm disturbance.
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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