The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?

Obtain consent for transesophageal echocardiogram (TEE)

Obtain consent for a STAT defibrillation

Obtain consent for cardioversion.

Hold digoxin 48 hours prior to cardioversion.

Answer and Explanation

The Correct Answer is B

Defibrillation is not the first-line treatment for atrial fibrillation. It is used to treat life-threatening cardiac arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia. Atrial fibrillation, on the other hand, is a rapid and irregular atrial rhythm, and defibrillation is not indicated for its treatment.

Obtain consent for transesophageal echocardiogram (TEE): This is an appropriate action for a client with atrial fibrillation. A TEE is often performed to assess the structure and function of the heart in cases of atrial fibrillation, especially when considering cardioversion or other interventions.

Obtain consent for cardioversion: Cardioversion is a common treatment option for atrial fibrillation, especially when the client is unstable or experiencing symptoms. It involves restoring a normal heart rhythm through the use of electrical shocks or medications. It is important to obtain informed consent before performing cardioversion, but this does not necessarily require questioning.

Hold digoxin 48 hours prior to cardioversion: Digoxin is commonly held before cardioversion because it can increase the risk of certain arrhythmias during the procedure. This is a standard precaution to minimize potential adverse effects. Therefore, the nurse does not need to question this action, as it aligns with established guidelines.

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Correct Answer is D

Explanation

Sinus bradycardia with a heart rate of 32 beats/min and accompanying hypotension and symptoms of feeling faint indicates significant hemodynamic compromise. In such cases, the first-line intervention is to provide external cardiac pacing through transcutaneous pacemaker (TCP) pads. TCP can help increase the heart rate and improve cardiac output by delivering electrical impulses to the heart.

Administering the scheduled dose of diltiazem (Cardizem), a calcium channel blocker, is not appropriate in this situation. Diltiazem can further lower the heart rate and blood pressure, exacerbating the client's symptoms and potentially leading to adverse effects.

Repositioning the patient on the left side or having the patient perform the Valsalva maneuver are not effective interventions for treating sinus bradycardia with hemodynamic compromise. These actions may be used in specific situations, but in this case, the client requires immediate intervention to address the low heart rate and blood pressure.

A. "I should never place items that generate magnetic fields over the pacemaker/ICD" B. "I should not play contact sports or lift heavy objects for two months" C. “I should inform dentists and health care providers about the pacemaker/ICD" D. “I should never allow metal detectors at the airport or the use of household appliances"

Correct Answer is D

Explanation

While it is generally recommended to avoid close or prolonged exposure to strong magnetic fields, such as those generated by MRI machines, placing items that generate magnetic fields over the pacemaker/ICD, such as cell phones or certain medical devices, does not typically pose a risk. Therefore, it would be important for the nurse to clarify the client's understanding and provide accurate information about the precautions related to magnetic fields.

The other statements made by the client are generally correct and align with the typical recommendations for individuals with pacemakers/ICDs:

Avoiding contact sports or lifting heavy objects for a specified period of time after pacemaker/ICD insertion is usually advised to allow for proper healing and to reduce the risk of lead dislodgment or damage to the device.

Informing dentists and healthcare providers about the presence of a pacemaker/ICD is important so that they can take appropriate precautions during procedures or treatments that may involve electromagnetic interference or interfere with the device's functioning.

While it is generally advised to avoid close proximity to strong magnetic fields, such as those in airports or certain household appliances, it does not necessarily mean completely avoiding them. The nurse can clarify the specific recommendations regarding metal detectors at airports and the safe use of household appliances.

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The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with sinus bradycardia at a rate of 32 beats/min, blood pressure (BP) of 80/42 mm Hg, and reports feeling faint. Which is the appropriate action?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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The nurse is reviewing the medical records of a client with atrial fibrillation. Which prescription should the nurse question?