The patient’s cardiac rhythm suddenly changes on the monitor.
There are no P waves, instead there are fibrillatory waves before each QRS complex.
How would the nurse interpret the rhythm?
Atrial Fibrillation
Sinus Tachycardia
Ventricular Tachycardia
Ventricular Fibrillation
The Correct Answer is A
Atrial fibrillation (AF) is characterized by the absence of P waves on the ECG, the presence of fibrillatory waves, and an irregularly irregular rhythm. This is due to chaotic electrical activity in the atria, which results in disorganized atrial contractions. The fibrillatory waves, which are often described as "f" waves or "sawtooth" waves, represent the rapid and irregular electrical activity in the atria. They are typically best seen in lead II, V1, or V2 of the ECG.
Here is a more detailed explanation of the key features of AF that support this answer:
Absence of P waves: In normal sinus rhythm, the P wave represents the electrical impulse that originates in the sinoatrial (SA) node and depolarizes the atria. In AF, the SA node is no longer in control of the atrial rhythm, and there is no organized atrial depolarization. As a result, P waves are absent on the ECG.
Presence of fibrillatory waves: The fibrillatory waves seen in AF represent the disorganized electrical activity in the atria. They are typically irregular in amplitude and frequency, and they can vary in appearance from patient to patient.
Irregularly irregular rhythm: The ventricular rhythm in AF is also irregular because the impulses from the atria are not conducted to the ventricles in a regular pattern. This results in an irregularly irregular rhythm, which is a hallmark feature of AF.
Key points to remember:
AF is the most common type of cardiac arrhythmia.
It can be asymptomatic or cause a variety of symptoms, including palpitations, shortness of breath, fatigue, and lightheadedness.
AF is a risk factor for stroke and heart failure.
Treatment for AF may include medications to control heart rate or rhythm, blood thinners to reduce the risk of stroke, and in some cases, procedures to restore normal heart rhythm.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale:
Duration of pain: Stable angina typically lasts for less than 5 minutes, while pain from a myocardial infarction (MI) typically lasts longer, often 20 minutes or more. This is because stable angina is caused by a temporary decrease in blood flow to the heart muscle, while an MI is caused by a complete blockage of blood flow, leading to more severe and prolonged pain.
Mechanism of pain: The pain in stable angina is due to ischemia, which is a lack of oxygen to the heart muscle. This occurs when the demand for oxygen by the heart muscle exceeds the supply of oxygenated blood.
Nitrates and ischemia: Nitrates, such as nitroglycerin, work by dilating the coronary arteries, which increases blood flow to the heart muscle and relieves ischemia. This is why nitroglycerin is often effective in relieving the pain of stable angina.
Choice B rationale:
Non-specific symptom: Shortness of breath can occur with both stable angina and MI, as well as other conditions such as lung disease or anxiety. Therefore, it is not a specific symptom that can be used to differentiate between the two conditions.
Choice C rationale:
Activity level: Stable angina is typically triggered by exertion or emotional stress, which increase the heart's demand for oxygen.
Rest and angina: The pain often subsides with rest or nitroglycerin.
MI and rest: In contrast, the pain of an MI can occur at rest and is not always relieved by nitroglycerin.
Choice D rationale:
Nitrates and stable angina: As mentioned earlier, nitrates are often effective in relieving the pain of stable angina.
Nitrates and MI: However, they may not be as effective in relieving the pain of an MI, as the blockage of blood flow is more severe.
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