NURS 222 Exam #1 Study Guide: Dysrhythmias
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Questions and Answers

Which sign is commonly associated with heart rate exceeding 100 beats per minute?

  • Hepatomegaly
  • Edema
  • Palpitations (correct)
  • Shortness of breath
  • In which type of dysrhythmia would you expect the heart rate to be less than 60 bpm?

  • Sinus bradycardia (correct)
  • Ventricular tachycardia
  • Atrial fibrillation
  • Sinus tachycardia
  • What is a critical nursing intervention for a patient experiencing dyspnea due to heart failure?

  • Monitor oxygen saturation (correct)
  • Increase fluid intake
  • Defer medication administration
  • Encourage physical activity
  • Which characteristic defines sinus tachycardia on an ECG?

    <p>P waves merging with T waves</p> Signup and view all the answers

    Which symptom is typically associated with left-sided heart failure?

    <p>Pulmonary edema</p> Signup and view all the answers

    What does a normal PR interval range from?

    <p>0.12 to 0.20 seconds</p> Signup and view all the answers

    What is indicated if a patient has an increased volume and pressure in the venous system?

    <p>Heart failure</p> Signup and view all the answers

    Which intervention is necessary if a patient's oxygen saturation falls below 94%?

    <p>Provide oxygen therapy</p> Signup and view all the answers

    What is the CD4 count threshold indicating significant immune suppression in Stage III (AIDS)?

    <p>200 cells/mm^3</p> Signup and view all the answers

    Which of the following is NOT a common opportunistic pathogen in HIV patients during Stage I and II?

    <p>Chickenpox</p> Signup and view all the answers

    During an occupational exposure to HIV, when should Post-Exposure Prophylaxis (PEP) ideally be initiated?

    <p>Within 1-2 hours</p> Signup and view all the answers

    What type of anemia is primarily due to dietary deficiency of iron?

    <p>Iron deficiency anemia</p> Signup and view all the answers

    Which assessment is NOT included when evaluating HIV risk in a patient's sexual history?

    <p>Type of contraceptives used</p> Signup and view all the answers

    Which nursing intervention is most appropriate for a patient experiencing dyspnea?

    <p>Position the patient in high fowlers.</p> Signup and view all the answers

    What is a common sign of chronic obstructive pulmonary disease (COPD)?

    <p>Increased hematocrit levels due to low oxygen levels.</p> Signup and view all the answers

    What should be assessed in a patient with mitral valve prolapse?

    <p>Vital signs and the presence of specific symptoms.</p> Signup and view all the answers

    What is the main function of the first chamber in a three-chamber drainage system?

    <p>Collects drainage</p> Signup and view all the answers

    Which test can detect HIV antibodies as early as 2-6 weeks after exposure?

    <p>HIV Antigen/Antibody test (4th generation)</p> Signup and view all the answers

    Which medication category is commonly administered for managing pulmonary edema?

    <p>Diuretics.</p> Signup and view all the answers

    What symptom is most likely to be observed in a patient with chronic bronchitis?

    <p>Productive cough.</p> Signup and view all the answers

    Which item is NOT essential to keep within reach for emergencies related to a chest drainage system?

    <p>Portable X-ray machine</p> Signup and view all the answers

    Which assessment finding would suggest worsening respiratory function in a COPD patient?

    <p>Increase in accessory muscle use.</p> Signup and view all the answers

    What is the primary method of HIV transmission?

    <p>Through blood, semen, vaginal fluid, and breast milk</p> Signup and view all the answers

    Which food is NOT recommended for increasing oral iron intake?

    <p>Rice</p> Signup and view all the answers

    Which sign indicates a potential respiratory distress in a patient with a chest tube drainage system?

    <p>Changes in oxygen saturation</p> Signup and view all the answers

    What test result indicates hypoxemia in a patient?

    <p>PaO2 &lt; 80.</p> Signup and view all the answers

    What is a common treatment option for severe iron deficiency anemia?

    <p>Parenteral iron solutions</p> Signup and view all the answers

    Which of the following is NOT a rich source of Vitamin B12?

    <p>Dried beans</p> Signup and view all the answers

    What type of white blood cells does HIV predominantly destroy?

    <p>CD4 T helper cells</p> Signup and view all the answers

    Which of the following is a nursing priority in managing a patient with decreased gas exchange?

    <p>Monitoring respiratory rate regularly.</p> Signup and view all the answers

    Which of the following is NOT a responsibility of the nurse managing a chest drainage system?

    <p>Assess for signs of blood clots</p> Signup and view all the answers

    What distinguishes sickle cell disease from normal hemoglobin?

    <p>Shape of the cells</p> Signup and view all the answers

    Which pain management approach is NOT recommended for severe pain in sickle cell disease?

    <p>Using PRN (as needed) schedules for medication</p> Signup and view all the answers

    Which form of HIV is the most common subtype globally?

    <p>HIV-1</p> Signup and view all the answers

    To prevent a sickle cell crisis, patients should increase their daily liquid intake to at least how many liters?

    <p>3 to 4 L</p> Signup and view all the answers

    What should patients with sickle cell disease avoid to reduce the risk of crisis?

    <p>Strenuous physical exercise</p> Signup and view all the answers

    Which method is NOT a common treatment for Vitamin B12 anemia?

    <p>Use of iron supplements</p> Signup and view all the answers

    Study Notes

    Chapter 28: Dysrhythmias (Arrhythmia)

    • Signs and symptoms include palpitations, chest discomfort, shortness of breath, dizziness, fatigue, anxiety, confusion, and sweating.
    • Nursing interventions should involve monitoring vital signs, administering medications, providing oxygen if saturation is below 94%, and applying a 12-lead ECG.
    • In cases of inadequate heart rate increase, prepare for transcutaneous/transvenous pacing; permanent pacemaker may be needed for persistent dysrhythmias.

    Sinus Tachycardia

    • Heart rate exceeds 100 bpm but typically under 180 bpm; rhythm is regular with well-defined P waves preceding each QRS complex.
    • PR interval remains consistent at 0.12 to 0.20 seconds; QRS complex duration is under 0.12 seconds.

    Sinus Bradycardia

    • Characterized by a heart rate below 60 bpm; maintains normal, upright P waves in lead II.
    • PR interval is 0.12 to 0.20 seconds, indicating consistency.

    Chapter 29: Cardiac Conditions

    Heart Failure

    • Left-sided heart failure symptoms include pulmonary edema, dyspnea, fatigue, weakness, and chest pain; right-sided symptoms include jugular venous distension (JVD), ascites, and peripheral edema.
    • Nursing teaching focuses on lifestyle modifications, medication adherence, and recognizing common signs/symptoms.
    • Interventions include monitoring respiratory rate, auscultating breath sounds, positioning for comfort, medication administration (ACE inhibitors, diuretics), and daily weight checks.

    Mitral Valve Prolapse

    • Enlarge and prolapse of leaflets into the left atrium, often asymptomatic; may cause chest pain, palpitations, or a midsystolic click.
    • Nursing interventions include vital sign assessment, auscultation, and symptom monitoring.

    Chronic Obstructive Pulmonary Disease (COPD)

    • Symptoms include dyspnea, productive cough, hypoxemia, barrel chest, and cyanosis.
    • Laboratory evaluations consist of hematocrit levels, sputum cultures, ABGs (PaO2 < 80; PaCO2 > 45), PFTs, and chest x-rays.
    • Pathophysiology includes chronic bronchitis (mucus overproduction) and emphysema (over-distended alveoli).
    • Risk factors involve smoking, air pollution exposure, and history of respiratory infections.

    Chest Tube Management

    • Priority of care includes monitoring vital signs (O2 saturation and respiratory rate), frequent position changes, and assessing for leakage.
    • Utilize a three-chamber drainage system: drainage collection, water seal, and suction control.
    • Nurse responsibilities include ensuring patency of tubes, monitoring for respiratory distress, and maintaining documentation of output.

    Chapter 17: Human Immunodeficiency Virus (HIV)

    • HIV attacks the immune system, specifically CD4 T-helper cells; AIDS is the most severe stage with significant immunosuppression.
    • Transmission occurs via blood, sex, and breast milk; two main types are HIV-1 (common) and HIV-2.

    Laboratory Diagnosis

    • Serologic tests (ELISA, Western Blot) typically positive within 3-12 weeks; 4th generation tests can detect earlier (2-6 weeks).
    • Virologic tests measure the virus directly (HIV RNA, DNA tests).

    Signs and Symptoms

    • Stage I and II may be asymptomatic or present with flu-like symptoms; opportunistic infections are assessable.
    • Stage III (AIDS) exhibits severe immune suppression with CD4 counts below 200 cells/mm³ and significant weight loss.

    Occupational Needlestick Protocol

    • Cleanse the wound and report the incident; perform risk assessment and initiate PEP within 1-2 hours.
    • Follow with baseline and follow-up testing for HIV, Hepatitis B, and Hepatitis C.

    Chapter 34: Hematology Conditions

    Anemia

    • Defined as a reduction in RBC count, hemoglobin, or hematocrit; it signals various health issues.
    • Nutritional anemias include iron, vitamin B12, and folic acid deficiencies.
    Nutritional Anemia Management
    • Iron deficiency: Increase iron-rich foods and consider oral or parenteral iron supplements.
    • Vitamin B12 deficiency: Focus on animal proteins and consider injections, oral, or nasal forms.
    • Folic acid deficiency: Maintain a diet rich in folate and B12.

    Sickle Cell Disease

    • Genetic disorder causing abnormal hemoglobin formation; results in distorted red blood cells that can obstruct blood flow.
    • Symptoms include pain crises managed with IV analgesics and hydration; educate on lifestyle adjustments to prevent crises.
    • Monitoring includes HPLC and hemoglobin S testing.

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    Description

    Prepare for Exam #1 in NURS 222 with this focused study guide on dysrhythmias. Review essential signs and symptoms, as well as critical nursing interventions necessary for effective patient care. This guide serves as a comprehensive tool for understanding arrhythmias in nursing practice.

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