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1st, 2nd, and 3rd Degree Heart Block - Complications -
correct answer- -Cardiac arrest (cessation of all
heart activity)
-arrhythmia (irregular heart beat)
-bradycardia
-sudden cardiac death
- No complications for 1st degree heart block
1st, 2nd, and 3rd Degree Heart Block - Manifestations -
correct answer- First degree: no symptoms or
treatment; prolonged PR interval
Second degree: mild symptoms (fatigue, chest pain,
shortness of breath, nausea), may treat with pacemaker;
dropped QRS complex
,Third degree: sudden onset of dizziness, fatigue, shortness
of breath, low heart rate, cardiac arrest, may need
defibrillation and pacemaker
1st, 2nd, and 3rd Degree Heart Block - PATHO -
correct answer- Hear Block occurs when
electrical conduction is excessively delayed or stopped at
the AV node or Bundle of His.
First degree: the conduction delay prolongs the PR
interval, the time between the atrial and ventricular
contractions.
Second degree: the longer delay leads periodically to a
missed ventricular contraction. Cardiac output is
periodically decreased. (Type 1: every second to third
atrial beat is dropped at the AV node) (Type 2: electrical
signal sometimes gets to ventricle and sometimes does
not; can lead to total heart block)
Third degree (total block): there is no transmission of
impulses from the atria to the ventricles. The ventricles
,contract spontaneously at a slow rate of 30-45 beats per
minute, totally independent of the atrial contraction, with
continues normally. Cardiac output is greatly reduced,
causing fainting (syncope) and cardiac arrest.
27 year old male presents to the ED with chest pain onset
2 hours ago. Pain began while pt was at rest, sitting on the
couch. Pt reports difficulty breathing and increase pain on
inhalation. Vital signs: BP 92/63, HR 112, RR 28. Pt has no
prior cardiac or respiratory history. Which diagnostic test
and nursing diagnosis would be most appropriate for this
patient?
A. EKG, Acute Pain r/t Muscle Strain
B. Chest X-Ray, Ineffective airway clearance r/t Tension
Pneumothorax
C. CT Chest, Ineffective breathing pattern r/t Open
Pneumothorax
D. Basic Metabolic Panel, Risk for hypoxia r/t Respiratory
Acidosis - correct answer- Correct answer: B
Rationale: This patient experienced a spontaneous
pneumothorax that progressed into a tension
pneumothorax in the time it took for him to seek medical
treatment. The patient's VS suggest vascular impairment
, and potential shock. The progression of respiratory
distress should lead the RN to think tension pneumo vs a
stable or closed pneumo.
A: Incorrect because the scenario does not suggest the
patient experienced any trauma to cause the muscle
strain and an EKG could not contribute to the diagnosis
C: Incorrect because the patient did not experience any
trauma to cause an open pneumothorax and the primary
issue is the patient's airway clearance, not breathing
pattern
D: Incorrect because, it just is :) :)
A 60 year old male patient comes into the ER, complaining
of blurred vision. A urinalysis is performed with results of
blood in the urine, the medical team begins to suspect
Nephrosclerosis. What would the nurse expect to find in
the patients medical history?
A. Hypertension
B. Urolithiasis
C. Cystitis
D. Agenesis - correct answer- A. Hypertension:
is the correct answer since a patient with a chronic history