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1. Question
The client has developed atrial fibrillation, with a ventricular rate of 150 beats/minute. The nurse should assess the client for which associated signs and/or symptoms?
Correct
Answer: Option 3 is the correct answer.
Rationale: The client with uncontrolled atrial fibrillation with a ventricular rate more than 100 beats/minute is at risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations, chest pain or discomfort, hypotension, pulse deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and distended neck veins. Test-Taking Strategy: Focus on the subject, signs and/or symptoms associated with atrial fibrillation. Flat neck veins are normal or indicate hypovolemia, so this option can be eliminated. Nausea and vomiting are associated with vagus nerve activity and do not correlate with a tachycardic state. From the remaining options, think of the consequences of a falling cardiac output to direct you to the correct voption.
Incorrect
Answer: Option 3 is the correct answer.
Rationale: The client with uncontrolled atrial fibrillation with a ventricular rate more than 100 beats/minute is at risk for low cardiac output because of loss of atrial kick. The nurse assesses the client for palpitations, chest pain or discomfort, hypotension, pulse deficit, fatigue, weakness, dizziness, syncope, shortness of breath, and distended neck veins. Test-Taking Strategy: Focus on the subject, signs and/or symptoms associated with atrial fibrillation. Flat neck veins are normal or indicate hypovolemia, so this option can be eliminated. Nausea and vomiting are associated with vagus nerve activity and do not correlate with a tachycardic state. From the remaining options, think of the consequences of a falling cardiac output to direct you to the correct voption.
Atrial fibrillation
Description
Multiple rapid impulses from many foci depolarize
in the atria in a totally disorganized manner at a rate of 350 to 600 times/minute.
The atria quiver, which can lead to the
formation of thrombi.
Usuallyno definitivePwavecan beobserved, only
fibrillatory waves before each QRS.
Interventions
Administer oxygen.
Administer anticoagulants as prescribed because
of the risk of emboli.
Administercardiacmedicationsasprescribed to
control the ventricular rhythm and assist in the maintenance of cardiac output.
Prepare the client for cardioversion as prescribed.Instruct
the client in the use of medications as prescribed to control the dysrhythmia.
