A patient's cardiac monitor shows sinus rhythm, rate 64. The P-R interval is 0.18 seconds at 1:00 AM, 0.22 seconds at 2:30 PM, and 0.28 seconds at 4:00 PM. Which action should the nurse take next?
a. Place the transcutaneous pacemaker pads on the patient.
b. Administer atropine sulfate 1 mg IV per agency dysrhythmia protocol.
c. Document the patient's rhythm and assess the patient's response to the rhythm.
d. Call the health care provider before giving the next dose of metoprolol (Lopressor).
ANS: D
The patient has progressive first-degree atrioventricular (AV) block, and the ?-blocker should be held until discussing the medication with the health care provider. Documentation and assessment are appropriate but not fully adequate responses. The patient with first-degree AV block usually is asymptomatic, and a pacemaker is not indicated. Atropine is sometimes used for symptomatic bradycardia, but there is no indication that this patient is symptomatic.
You might also like to view...
A client is scheduled for a traditional esophagogastrostomy. All preoperative teaching has been completed and the client and family show good understanding. What action by the nurse is best?
a. Arrange an intensive care unit tour. b. Assess the client's psychosocial status. c. Document the teaching and response. d. Have the client begin nutritional supplements.
The physician has just told a patient that he has stage 4 lung cancer and likely has only months to live
After the physician leaves, the patient, who is visibly shaken, asks the nurse, "Couldn't the doctor be wrong? Is it really that bad?" The nurse explains to him that, although there is no way to know for certain how the disease will progress, the stage of his lung cancer is the most serious. The nurse also indicates that the cancer has spread to other organs in his body, meaning that the odds of recovery are not good. The patient then asks that the nurse not tell his wife, who is in the waiting room, about the diagnosis just yet. Later the patient's wife enters the room and, seeing that he is asleep, asks the nurse if there is any update on the patient's condition. The nurse explains that the doctor talked to the patient earlier and that the patient can provide details once he wakes up. Which ethical principle or principles has the nurse exercised in this situation? Select all that apply. A) Justice B) Fidelity C) Veracity D) Nonmaleficence
Which of the following precipitates 80% of the cases of aplastic crisis?
a. pneumococcal infection c. staphylococcus b. human parvovirus B-19 d. streptococcus
The central venous pressure of a patient with heart failure is slowly increasing. What does this finding suggest to the nurse?
1. Right heart function is deteriorating. 2. Left heart function is deteriorating. 3. Fluid is backing up in the lungs. 4. Right heart function is improving.