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1. Question
A client is having frequent premature ventricular contractions. The nurse should place priority on assessment of which item?
Correct
Answer: Option 3 is the correct answer.
Rationale: Premature ventricular contractions can cause hemodynamic compromise. Therefore, the priority is to monitor the blood pressure and oxygen saturation. The shortened ventricular filling time can lead to decreased cardiac output. The client may be asymptomatic or may feel palpitations. Premature ventricular contractions can be caused by cardiac disorders; states of hypoxemia; any number of physiological stressors, such as infection, illness, surgery, or trauma; and intake of caffeine, nicotine, or alcohol.
Test-Taking Strategy: Note the strategic word, priority. Use the ABCs—airway–breathing–circulation—to direct you to the correct option.
Incorrect
Answer: Option 3 is the correct answer.
Rationale: Premature ventricular contractions can cause hemodynamic compromise. Therefore, the priority is to monitor the blood pressure and oxygen saturation. The shortened ventricular filling time can lead to decreased cardiac output. The client may be asymptomatic or may feel palpitations. Premature ventricular contractions can be caused by cardiac disorders; states of hypoxemia; any number of physiological stressors, such as infection, illness, surgery, or trauma; and intake of caffeine, nicotine, or alcohol.
Test-Taking Strategy: Note the strategic word, priority. Use the ABCs—airway–breathing–circulation—to direct you to the correct option.
Premature ventricular contractions
Description
Early ventricular contractions result from increased
irritability of the ventricles.
PVCs frequently occur in repetitive patterns such
as bigeminy, trigeminy, and quadrigeminy.
The QRS complexes may be unifocal or multifocal.
Interventions
Identify the cause and treat on the basis of the
cause.
Evaluate oxygen saturation to assess for
hypoxemia, which can cause PVCs.
Evaluate electrolytes, particularly the
potassium level, because hypokalemia can cause PVCs.
Oxygen and medication may be prescribed in the
case of acute myocardial ischemia or MI.
