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Question 1 of 2
1. Question
The client has developed atrial fibrillation, with a ventricular rate of 150 beats per minute. The nurse should assess the client for which associated signs and/or symptoms? Select all that apply.
Correct
Option A, B, and C are correct:
Rationale: The client with uncontrolled atrial fibrillation with a ventricular rate more than 100 beats per 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. Hypertension and flat neck veins are not associated with the loss of cardiac output.
Incorrect
Option A, B, and C are correct:
Rationale: The client with uncontrolled atrial fibrillation with a ventricular rate more than 100 beats per 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. Hypertension and flat neck veins are not associated with the loss of cardiac output.
Question 2 of 2
2. Question
The nurse is watching the cardiac monitor, and a client’s rhythm suddenly changes. There are no P waves; instead, there are fibrillatory waves before each QRS complex. How should the nurse interpret the client’s heart rhythm?
Correct
Option A is the correct answer:
Rationale: Atrial fibrillation is characterized by a loss of P waves and fibrillatory waves before each QRS complex. The atria quiver, which can lead to thrombus formation.
Test-Taking Strategy: Focus on the subject, interpreting a heart rhythm. Note the data in the question. Noting the words There are no P waves should direct you to the correct option. Loss of P waves is characteristic of this dysrhythmia.
Incorrect
Option A is the correct answer:
Rationale: Atrial fibrillation is characterized by a loss of P waves and fibrillatory waves before each QRS complex. The atria quiver, which can lead to thrombus formation.
Test-Taking Strategy: Focus on the subject, interpreting a heart rhythm. Note the data in the question. Noting the words There are no P waves should direct you to the correct option. Loss of P waves is characteristic of this dysrhythmia.
Atrial fibrillation causes a rapid, disorganized, and uncoordinated twitching of atrial musculature. It is the most common dysrhythmia that causes patients to seek medical attention. It may start and stop suddenly. Atrial fibrillation may occur for a very short time (paroxysmal), or it may be chronic.
Atrial fibrillation is usually associated with advanced age, valvular heart disease, coronary artery disease, hypertension, cardiomyopathy, hyperthyroidism, pulmonary disease, acute moderate to heavy ingestion of alcohol (“holiday heart” syndrome), or the aftermath of open heart surgery. Sometimes it occurs in people without any underlying pathophysiology (termed lone atrial fibrillation).
