The nurse understands that chest pain related to pericarditis is classically relieved by

gabapentin & acetaminophen

extended release opioids

sitting & leaning forward

supine with head of bed 15 degrees

Answer and Explanation

The Correct Answer is C

A. gabapentin & acetaminophen: While acetaminophen may help with pain relief, gabapentin is primarily used for neuropathic pain and not effective for the inflammatory chest pain associated with pericarditis. These medications do not address the positional nature of pericardial pain.

B. extended release opioids: Opioids may provide general pain relief but are not the standard treatment for pericarditis-related pain. They do not address the inflammatory cause and carry risks of sedation and respiratory depression without improving cardiac inflammation.

C. sitting & leaning forward: Pericarditis pain is classically relieved by having the patient sit up and lean forward. This position reduces pressure on the pericardium and decreases pain by allowing the inflamed pericardial layers to separate slightly, reducing friction.

D. supine with head of bed 15 degrees: Lying flat or even slightly elevated can worsen pericarditis pain because it increases pressure on the inflamed pericardium. Patients often report increased discomfort in the supine position, making it less favorable for symptom relief.

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Correct Answer is A

Explanation

A. Atrial fibrillation: Atrial fibrillation is characterized by an irregularly irregular rhythm, absence of identifiable P waves, and an unmeasurable PR interval. The ventricular rate can vary (in this case, 92/min), and QRS duration is usually normal. These findings match the classic ECG criteria for atrial fibrillation.

B. Sinus bradycardia: Sinus bradycardia features a regular rhythm, visible P waves before each QRS, and a rate below 60 bpm. The client's rate is 92 and the rhythm is irregular, ruling out this option.

C. Supraventricular tachycardia: SVT typically presents with a regular, rapid rhythm, often over 150 bpm, and P waves may be hidden in the preceding T wave. The client’s rate is 92 with an irregular rhythm, which does not fit SVT.

D. First-degree heart block: First-degree AV block is defined by a prolonged PR interval (>0.20 seconds) with otherwise normal sinus rhythm. In this case, the PR interval is unmeasurable and the rhythm is irregular, making this diagnosis unlikely.

A. Administer amiodarone IV push followed by a continuous infusion. B. Establish unresponsiveness and check the carotid pulse. C. Immediately defibrillate the client using the synchronous mode. D. Initiate a rapid response call and increase the monitor's sensitivity.

Correct Answer is B

Explanation

A. Administer amiodarone IV push followed by a continuous infusion: Amiodarone is part of the Advanced Cardiac Life Support (ACLS) algorithm for ventricular fibrillation (VF) or pulseless ventricular tachycardia, but it should only be given after confirming the rhythm and initiating basic life support steps, including pulse check.

B. Establish unresponsiveness and check the carotid pulse: The rhythm strip shows ventricular fibrillation, a life-threatening arrhythmia. However, before initiating advanced interventions such as defibrillation, the nurse must first confirm the client is unresponsive and pulseless, which is the correct initial action according to ACLS protocols.

C. Immediately defibrillate the client using the synchronous mode: Defibrillation is the correct treatment for VF, but it must be done in unsynchronized mode. Additionally, it is not appropriate to defibrillate until pulselessness is confirmed. Synchronized mode is used for rhythms like unstable SVT or atrial fibrillation not VF.

D. Initiate a rapid response call and increase the monitor’s sensitivity: A rapid response team is called for deteriorating patients who are still responsive. If the client is unresponsive and pulseless, a code blue or cardiac arrest protocol should be initiated, not just a rapid response. Monitor sensitivity adjustments are irrelevant in a confirmed life-threatening rhythm.

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The nurse understands that chest pain related to pericarditis is classically relieved by

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