A client is in the hospital for the placement of a pacemaker. The nurse suspects that the client might have a problem with:
1. The bundle of His.
2. The contraction of the left atrium.
3. Damage to the endocardium.
4. A blockage in cardiac circulation.
Answer: 1
1. The bundle of His is part of the electrical conduction of the heart, which can be damaged during a myocardial infarction. If damaged, electrical impulses from the atrium will not reach the ventricle to stimulate contraction. A pacemaker takes the place of a damaged pathway.
2. The beginning of the electrical system is the sinoatrial node, which is located in the right atrium.
3. The endocardium is part of the wall of the heart, which does not factor into the electrical conduction.
4. A block in cardiac circulation is caused by a clot formation or a buildup of plaque that prevents blood from reaching the heart. The vascular system does not affect conduction.
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