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The ________ ________ in the heart is made up of specialized cells that generate and transmit electrical impulses.
conduction system
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__________ and __________ followed by the mechanical contraction and __________ of the cardiac muscle constitute one complete cardiac cycle.
depolarization, depolarization, relaxation
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Patients may require ______ ______ ______ while in the acute care setting.
continuous cardiac monitoring
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__________ are a common occurrence and vary from causing no symptoms to being life threatening.
Arrhythmias
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Normal sinus rhythm has a rate of _____ to _____ beats per minute with a regular rhythm.
60 to 100
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Ventricular arrhythmias can be detected by changes in the _____ complexes and are the most serious of the arrhythmias.
QRS
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Benefits of using __________ medications should out-weight the risk for the patient to be started on medication.
anti-arrhythmic
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__________ depolarizes the heart so that there is a short period of systole in an effort to stop the arrhythmia and allow the heart to resume normal activity.
defibrillation
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_________ _________ is the delivery of energy to the heart synchronized on the patient's R wave.
synchronized cardioversion
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_______ is the process of artificially supporting a patient's breathing and heartbeat when respirations and pulse have ceased.
CPR
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An ______ _______ _______ analyzes heart rhythms and tells the operator when to perform defibrillation.
automatic external defibrillator
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________ incorporates advanced lifesaving techniques, medications, and interventions in addition to BLS during a cardiopulmonary arrest.
ACLS
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Ventricular fibrillation and pulseless ventricular tachycardia should be treated with immediate __________.
defibrillation
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The _________ _________ emphasizes the importance of treating only the symptomatic bradycardias.
bradycardia algorithm
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An ________ is available to assist the health care provider in identifying patients at risk of developing unstable ________.
algorithm; tachycardias
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During an analysis of an ECG strip, the critical care nurse assesses heart rate. If the rhythm is irregular, which is the best way to calculate heart rate per minute from a rhythm strip?
- a. count the number of tiny boxes btw two R waves and divide by 1500
- b. count the number of QRS complexes in a three-second strip and multiply by 25
- c. count the number of QRS complexes in a six-second strip and multiple by 10
- d. count the number of large boxes btw two R waves and divide by 300
C: this is the appropriate way to calculate the heart rate from a strip when it is irregular
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Phase zero (depolarization) of the action potential begins when _______ ions move into the cardiac cell.
a. sodium
b. potassium
c. magnesium
d. chloride
A: sodium ions move into the cell to initiate depolarization
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The nurse responds to a telemetry alarm that shows a client to be asystole. What should the first action be?
a. defibrillate
b. initiate cardiac pacing
c. begin CPR
d. establish unresponsiveness
D: the nurse should establish unresponsiveness prior to initiating CPR
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A client displays a supra ventricular tachycardia with a heart rate of 180 beats per minute. He complains of dizziness, nausea, and chest pain. The client's blood pressure is 90/60. The nurse knows that the most appropriate intervention for this client is to:
a. defibrillate
b. administer an angiotensin-converting enzyme (ACE) inhibitor
c. start a dopamine drip
d. ask the client to cough
D: asking the client to cough may cause a vagal response, which would slow the heart rate down
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A client suddenly becomes unresponsive and pulseless and displays a flatline rhythm on the monitor. The best initial intervention by the nurse is:
a. CPR
b. defibrillation
c. aminodarone
d. transvenous pacing
A: the electrical rhythm is normal sinus rhythm, but the client has no pulse. The interpretation should be PEA, in which case CPR should be started.
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A client is exhibiting a normal sinus rhythm with a blood pressure of 100/58. He denies chest pain or dyspnea at this time. The most appropriate intervention at this time is:
a. transcutaneous pcing
b. atropine
c. Isuprel
d. to continue to monitor the client
D: The client is not suffering from hemodynamic instability at this time. It is important to continue to monitor the client in a sinus bradycardia.
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Treatment for ventricular tachycardia with a pulse could include these interventions (select all that apply):
a. defibrillation
b. amiodarone
c. vasopressin
d. synchronized cardioversion
e. lidocaine hydrochloride
f. epinephrine
B, D, E
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The most appropriate treatment for ventricular fibrillation after defibrillation attempts is:
a. three more defibrillation attempts
b. epinephrine
c. atropine
d. synchronized cardioversion
B: epinephrine will be given after three attempts in ventricular fibrillation
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Ventricular arrhythmias will be interpreted on the rhythm strip by primarily analyzing the:
a. T wave
b. P wave
c. PR interval
d. QRS complex
D: ventricular arrhythmias are primarily interpreted by analyzing the QRS complex as it represents ventricular depolarization
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Which of the following is true concerning the primary survey associated with ACLS?
a. advanced airway devices, such as endotracheal intubation or emergent trachyostomy, are used.
b. IV lines should be started to deliver emergency medications.
c. the letter D in the secondary survey stands for defibrillation.
d. the health care provider assesses and manages breathing by using positive-pressure ventilations.
D: the health care provider assesses and manages breathing by using positive-pressure ventilations
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