The nurse is caring for a client on a telemetry unit. The client's cardiac monitor exhibits the rhythm below. How should the nurse document this rhythm?

Sinus rhythm with first-degree heart block

ST-segment elevation myocardial infarction (STEMI)

Atrial fibrillation

Ventricular tachycardia

Answer and Explanation

The Correct Answer is B

A. Sinus rhythm with first-degree heart block: This rhythm is characterized by a regular sinus rhythm with a prolonged PR interval (greater than 0.20 seconds), indicating a first-degree heart block.

B. ST-segment elevation myocardial infarction (STEMI): STEMI is indicated by significant ST-segment elevation in specific leads, showing acute myocardial infarction.

C. Atrial fibrillation: Atrial fibrillation shows an irregularly irregular rhythm without distinct P waves.

D. Ventricular tachycardia: Ventricular tachycardia is a rapid heart rhythm originating from the ventricles, with wide QRS complexes and no preceding P waves.

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Correct Answer is D

Explanation

A. Removing the cast correctly at the end of the treatment period. The nurse would not instruct the patient to remove the cast. This should be done by a healthcare provider at the appropriate time.

B. Using crutches efficiently. While crutch use is important, it is secondary to monitoring for impaired circulation, which can have immediate, serious consequences.

C. Exercising joints above and below the cast, as prescribed. This may be part of rehabilitation but does not have the same urgency as monitoring circulation for complications.

D. Reporting signs of impaired circulation. The nurse should emphasize the importance of monitoring for signs of impaired circulation, such as increased pain, numbness, or color changes, which could indicate complications like compartment syndrome or poor blood flow.

A. Heart rate of 134 bpm B. Mild shortness of breath C. Three premature ventricular contractions in a row D. Blood pressure 152/88 mmHg

Correct Answer is C

Explanation

A. Heart rate of 134 bpm. A heart rate of 134 bpm is expected during a cardiac stress test, as the goal is to increase the heart rate to a target range to evaluate cardiac function under stress.

B. Mild shortness of breath. Mild shortness of breath is a common response to exercise and is not an indication to stop the test unless it becomes severe or is accompanied by other concerning symptoms like chest pain or cyanosis.

C. Three premature ventricular contractions in a row indicate a potential serious arrhythmia (ventricular tachycardia), which is a contraindication for continuing the stress test. This finding could place the client at risk for life-threatening cardiac events, such as ventricular fibrillation.

D. Blood pressure 152/88 mmHg. This is a slightly elevated but normal physiological response to exercise and does not warrant discontinuation of the test unless the blood pressure rises to dangerously high levels (e.g., >200/110 mmHg).

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The nurse is caring for a client on a telemetry unit. The client's cardiac monitor exhibits the rhythm below. How should the nurse document this rhythm?

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