The nurse is caring for a patient with refractory atrial fibrillation who underwent the maze procedure several months ago.
The nurse reviews the result of the patient’s most recent cardiac imaging, which notes the presence of scarring on the atria.
Recognize that the procedure was unsuccessful.
Prepare the patient for pacemaker implantation.
Consult with the care team in preparation for repeating the maze procedure.
Recognize this as a therapeutic goal of the procedure.
The Correct Answer is C
Choice A rationale:
Incorrect. Scarring on the atria is not an indication of procedure failure in the context of the maze procedure. In fact, it's a desired outcome.
Pacemaker implantation: Not routinely indicated after the maze procedure, even if scarring is present. Pacemakers are primarily used to treat bradyarrhythmias (slow heart rhythms), not atrial fibrillation.
Choice B rationale:
Incorrect. Repeating the maze procedure is generally not considered unless there's clear evidence of recurrent atrial fibrillation despite initial scarring. Scarring formation takes time, and premature repeat procedures are often not necessary.
Consulting the care team: While collaboration is essential, consultation specifically for repeating the procedure based solely on scarring would be premature.
Choice C rationale:
Correct. The maze procedure intentionally creates scar tissue within the atria to block abnormal electrical signals that cause atrial fibrillation. Scarring disrupts the pathways that allow these signals to circulate and trigger fibrillation. Therefore, the presence of scarring is a positive finding that suggests the procedure has achieved its intended effect.
Choice D rationale:
Incorrect. Further diagnostic testing is not routinely indicated solely based on the presence of scarring after the maze procedure. Additional testing might be considered if the patient experiences recurrent atrial fibrillation or other concerning symptoms, but scarring itself does not necessitate immediate further investigation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale:
LDL (low-density lipoprotein) cholesterol is often referred to as "bad" cholesterol. It contributes to the buildup of plaque in the arteries, which narrows the arteries and can lead to coronary artery disease (CAD). CAD is a major risk factor for heart attack and stroke.
HDL (high-density lipoprotein) cholesterol is often referred to as "good" cholesterol. It helps to remove LDL cholesterol from the arteries and transport it back to the liver, where it can be broken down and removed from the body. Therefore, a high HDL level is protective against heart disease.
An elevated LDL level and a lowered HDL level are both associated with an increased risk of CAD. This is because the elevated LDL level contributes to plaque buildup, while the lowered HDL level means that there is less "good" cholesterol available to remove the "bad" cholesterol from the arteries.
Therefore, the statement "Increased LDL and decreased HDL increase my risk of coronary artery disease" indicates an understanding of the significance of these cholesterol levels.
Choice A rationale:
This statement is incorrect. An increased LDL level will actually increase the amount of cholesterol deposited on the artery walls.
Choice C rationale:
This statement is also incorrect. A decreased HDL level will decrease the amount of cholesterol moved away from the artery walls.
Choice D rationale:
This statement is incorrect. Increased LDL has the potential to increase, not decrease, the risk of heart disease.
Correct Answer is A
Explanation
Choice A rationale:
Systole is derived from the Greek word "sustolē," meaning "contraction." This etymology directly aligns with the physiological process it describes.
During systole, the heart muscle contracts forcefully, generating the pressure necessary to propel blood out of the heart's chambers and into the circulatory system.
This phase is crucial for ensuring adequate blood flow to all tissues and organs, delivering oxygen and nutrients and removing waste products.
It's initiated by electrical signals generated by the sinoatrial node (SA node), the heart's natural pacemaker.
The electrical impulse travels through the heart's conduction system, triggering a coordinated contraction of the atria and ventricles.
Atrial systole occurs first, contributing to ventricular filling.
Ventricular systole follows, generating the powerful force that propels blood into the pulmonary artery (from the right ventricle) and the aorta (from the left ventricle).
Systolic blood pressure, the higher number in a blood pressure reading, measures the pressure in the arteries during ventricular systole.
Choice B rationale:
This choice describes diastole, the opposite phase of the cardiac cycle.
During diastole, the heart muscle relaxes, allowing the chambers to refill with blood.
Diastole is essential for proper heart function, ensuring that the heart can adequately fill with blood before the next systolic contraction.
Choice C rationale:
This choice refers to cardiac output, which is the total volume of blood pumped by the heart per minute.
Cardiac output is influenced by both heart rate and stroke volume (the amount of blood ejected from the ventricle with each contraction). Choice D rationale:
This choice describes ejection fraction, which is the percentage of blood that fills the ventricles during diastole that is then pumped out during systole.
Ejection fraction is a measure of the heart's pumping efficiency.
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