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Questions and Answers
What is the normal range for resting heart rate in Normal Sinus Rhythm?
What is the normal range for resting heart rate in Normal Sinus Rhythm?
What distinguishes a PR interval in a normal ECG reading?
What distinguishes a PR interval in a normal ECG reading?
During sinus tachycardia, what is the maximum expected heart rate?
During sinus tachycardia, what is the maximum expected heart rate?
Which symptom is NOT typically associated with sinus tachycardia?
Which symptom is NOT typically associated with sinus tachycardia?
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What change may occur to P waves at very fast rates during sinus tachycardia?
What change may occur to P waves at very fast rates during sinus tachycardia?
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What is the significance of the QRS complex being less than 0.12 seconds in sinus tachycardia?
What is the significance of the QRS complex being less than 0.12 seconds in sinus tachycardia?
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What assessment should be done for patients experiencing sinus tachycardia?
What assessment should be done for patients experiencing sinus tachycardia?
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Which of the following is a characteristic of Normal Sinus Rhythm?
Which of the following is a characteristic of Normal Sinus Rhythm?
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What height should the T wave generally be in a normal ECG?
What height should the T wave generally be in a normal ECG?
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What is one of the primary physiological consequences of cor pulmonale due to severe COPD?
What is one of the primary physiological consequences of cor pulmonale due to severe COPD?
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Which sign is NOT typically associated with cor pulmonale?
Which sign is NOT typically associated with cor pulmonale?
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What indicates that an air leak is occurring in the chest tube drainage system?
What indicates that an air leak is occurring in the chest tube drainage system?
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What is the role of reverse transcriptase in the HIV virus?
What is the role of reverse transcriptase in the HIV virus?
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Which of the following statements is true regarding the relationship between HIV and AIDS?
Which of the following statements is true regarding the relationship between HIV and AIDS?
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In the management of a chest tube system, which of the following is crucial for patient care?
In the management of a chest tube system, which of the following is crucial for patient care?
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What symptom is commonly reported by some individuals with mitral valve issues?
What symptom is commonly reported by some individuals with mitral valve issues?
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Which dietary restriction is recommended for patients with mitral valve problems?
Which dietary restriction is recommended for patients with mitral valve problems?
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What is a primary characteristic of bronchitis compared to emphysema?
What is a primary characteristic of bronchitis compared to emphysema?
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What condition is commonly associated with a 'BLUE BLOATER' phenotype?
What condition is commonly associated with a 'BLUE BLOATER' phenotype?
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What symptom is NOT typically associated with chronic obstructive pulmonary disease?
What symptom is NOT typically associated with chronic obstructive pulmonary disease?
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What is a common risk factor for developing endocarditis in patients with mitral valve problems?
What is a common risk factor for developing endocarditis in patients with mitral valve problems?
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Which of the following symptoms is characteristic of emphysema?
Which of the following symptoms is characteristic of emphysema?
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What is a recommendation for patients with a tendency toward infection in relation to personal care?
What is a recommendation for patients with a tendency toward infection in relation to personal care?
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What is the primary impact of chronic bronchitis on airflow?
What is the primary impact of chronic bronchitis on airflow?
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What is the primary reason patients with heart valve issues are advised against body piercing?
What is the primary reason patients with heart valve issues are advised against body piercing?
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Which of the following should be monitored for older adults with frequency/incontinence?
Which of the following should be monitored for older adults with frequency/incontinence?
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What positioning technique helps alleviate fatigue in patients?
What positioning technique helps alleviate fatigue in patients?
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Which complication is associated with the use of diuretics in heart failure patients?
Which complication is associated with the use of diuretics in heart failure patients?
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What condition can result from volume depletion due to excessive fluid loss?
What condition can result from volume depletion due to excessive fluid loss?
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What is a primary goal of care in managing heart failure patients?
What is a primary goal of care in managing heart failure patients?
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Which symptom is indicative of mitral valve prolapse?
Which symptom is indicative of mitral valve prolapse?
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What should be monitored to prevent potential complications like dysrhythmias in heart failure patients?
What should be monitored to prevent potential complications like dysrhythmias in heart failure patients?
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What symptom can arise from prolonged diuretic use?
What symptom can arise from prolonged diuretic use?
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Which parameter is essential for diagnosing pulmonary edema?
Which parameter is essential for diagnosing pulmonary edema?
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Which of the following is a risk associated with hypomagnesemia in heart failure patients?
Which of the following is a risk associated with hypomagnesemia in heart failure patients?
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What is a common initial symptom of left ventricular failure?
What is a common initial symptom of left ventricular failure?
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Which finding may indicate acute decompensated heart failure with pulmonary edema?
Which finding may indicate acute decompensated heart failure with pulmonary edema?
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In left ventricular failure, what causes decreased renal perfusion and oliguria?
In left ventricular failure, what causes decreased renal perfusion and oliguria?
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Which symptom is commonly associated with inadequate brain perfusion due to heart failure?
Which symptom is commonly associated with inadequate brain perfusion due to heart failure?
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What cardiovascular response occurs due to decreased stroke volume in heart failure?
What cardiovascular response occurs due to decreased stroke volume in heart failure?
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What physical manifestation might indicate right-sided heart failure?
What physical manifestation might indicate right-sided heart failure?
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What system is often interfered with due to right-sided heart failure leading to fluid retention?
What system is often interfered with due to right-sided heart failure leading to fluid retention?
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Which physical symptom may be observed due to increased venous pressure in right-sided heart failure?
Which physical symptom may be observed due to increased venous pressure in right-sided heart failure?
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What is a common effect of fluid retention associated with heart failure?
What is a common effect of fluid retention associated with heart failure?
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What might cause a patient to experience nocturia in heart failure?
What might cause a patient to experience nocturia in heart failure?
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Study Notes
Dysrhythmias
- Dysrhythmias, also known as arrhythmias, are abnormal heart rhythms that impair cardiac efficiency in pumping oxygenated blood.
- Normal sinus rhythm (NSR) originates from the SA node with a resting heart rate of 60-100 bpm and a regular rhythm.
- Key characteristics of NSR:
- P waves: upright, consistent in size and shape, precede each QRS complex.
- PR interval: 0.12 to 0.20 seconds.
- QRS complex: lasts 0.04–0.44 seconds.
- ST segment: should be on the baseline.
- QT interval: varies but generally up to 0.44 seconds.
- T waves: usually positive and less than 5 mm in height.
Sinus Tachycardia
- Characterized by heart rates exceeding 100 bpm, typically not exceeding 180 bpm.
- Regular rhythm with visible P waves before each QRS complex; P waves may merge with T waves at high rates.
- PR interval is normal (0.12-0.20 seconds), and QRS complex remains under 0.12 seconds.
- Symptoms include:
- Often asymptomatic; possible hypovolemia, dehydration, decreased urinary output, and blood pressure.
- Dry skin/mucous membranes, anginal pain, and palpitations.
- Nursing interventions include vital signs monitoring and assessing for dysrhythmias.
Heart Failure Indicators
- Left ventricular failure leads to decreased cardiac output, which can cause:
- Dry/hack cough mistaken for asthma or COPD; may produce large quantities of pink frothy sputum in acute decompensated heart failure.
- Pulmonary crackles indicate fluid accumulation; may not clear with coughing.
- Low oxygen saturation and potential presence of S3 or gallop sounds.
- Right-sided heart failure symptoms include:
- JVD and peripheral edema, especially in feet and ankles, worsening with prolonged sitting or standing.
- Hepatomegaly and ascites, along with GI distress and weight gain due to fluid retention.
- Key nursing activities: monitoring fluid status, daily weights, adherence to low sodium diets, and anxiety management.
Mitral Valve Prolapse
- Occurs when mitral valve leaflets enlarge and prolapse into the left atrium during systole, which allows regurgitation of blood.
- Commonly asymptomatic but can manifest as fatigue, chest pain, SOB, dizziness, syncope, and palpitations.
- May result in a mid-systolic click and late systolic murmur.
- Nursing interventions include dietary restrictions (avoid stimulants), smoking cessation, and infection risk minimization.
Chronic Obstructive Pulmonary Disease (COPD)
- Symptoms include dyspnea, productive cough, wheezing, clubbing of fingers, and a barrel-shaped chest.
- Pathophysiology involves lower airway disorders affecting airflow and gas exchange, mainly emphysema and bronchitis.
- Emphysema: Overdistended alveoli, difficulty exhaling, chronic hypercapnia, known as "pink puffers."
- Bronchitis: Hypersecretion of mucus, difficulty inhaling, inflammation resulting in cyanosis, referred to as "blue bloaters."
- Cor pulmonale, a complication of severe COPD, may result in right ventricular hypertrophy and heart failure, presenting with symptoms like ascites and JVD.
Chest Tube Management
- Closed drainage systems are standard, with nursing responsibilities including monitoring for effective drainage and assessing the patient's respiratory status.
- Bubbling in the water-seal indicates air drainage; excessive bubbling suggests leaks while cessation could indicate blockage.
- Tidaling indicates normal respiratory movement.
- Nursing care includes:
- Regularly assessing lung sounds and breathing effectiveness.
- Inspecting the insertion site for infection or subcutaneous emphysema.
- Encouraging deep breathing and coughing with the use of incentive spirometry.
Human Immunodeficiency Virus (HIV)
- HIV leads to the progressive depletion of CD4 T cells vital for immune defense against infections.
- Understood as a retrovirus, it contains RNA and uses reverse transcriptase to convert RNA into DNA in host cells.
- It transforms CD4 cells into virus-producing factories, ultimately disabling them.
- Important distinction: all individuals with AIDS are HIV positive, but not all who have HIV develop AIDS.
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Description
Prepare for your NURS 222 Exam #1 with this comprehensive study guide focusing on Chapter 28: Dysrhythmias. Understand the abnormal rhythms of the heart's electrical system and how disturbances affect oxygen delivery. Emphasize the Normal Sinus Rhythm and key concepts crucial for your nursing exam.