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NUR2571: Professional Nursing II / PN 2 Exam 2 Study Guide
1. Effects of beta-blockers on heart and heart rate
-Beta Blocker will decrease Heart Rate and Blood pressure.
-Assess heart rate (HR) and blood pressure (BP) before administration because beta
blockers cause a decrease in HR and cardiac output and suppress renin activity.
• Do not administer if HR is <50-60 beats/min.
• Hold for systolic <90-100 mm HG and contact the health care provider.
• Monitor for orthostatic hypotension because this is a common adverse effect that can
contribute to falls and confusion, especially in older adults.
- Use with caution in patients with diabetes because glucose production may be affected.
- Teach the patient that these agents can cause fatigue, depression, and sexual
dysfunction. These adverse effects should be reported to the primary health care
provider.
2. Complications of atrial fibrillation
-Atrial fibrillation occurs commonly in clients with cardiac disease and is a common
reoccurrence after coronary artery bypass graft surgery.
-Clients are at risk for embolitic stroke. Evidence of embolitic events includes changes I
mentation, speech, sensory function, and motor function.
-Clients with A-fib often have a rapid ventricular response as a result.
- Clients with a-fib are at risk for decreased cardiac output and fatigue when completing
activities of daily living.
-Nursing Intervention: schedule periods of rest and exercise during the day.
-for patients with acute a-fib who have a cardioversion, the nurse should turn off
any oxygen therapy to prevent fire.
3. Complications from wide QRS and bradycardia combined, what does it
mean?
-An HR of 40 beats/min or less with widened QRS complexes could have hemodynamic
consequences. The client is at risk for inadequate cerebral perfusion. The nurse should
assess for level of consciousness, lightheadedness, confusion, syncope and seizure
activity.
4. What does pacer spikes without QRS complex imply and what
complication can it cause?
-Pacer spike without QRS complex imply “LOSS OF CAPTURE”. If there is no capture then
there is no ventricular depolarization and contraction. The nurse should assess for
cardiac output via vital signs and level of consciousness.
5. Precautions taken when the nurse uses a defibrillator
, 2
-PRIORITY: Ensure that everyone is clear of contact with the client and the bed**
-Epinephrine should be administered AFTER defibrillation
6. Know what V-Tach looks like on monitor and the treatment
-You MUST shock someone with ventricular tachycardia via defibrillator AND INITIATE
CARDIO-PULMONARY RESUSCITATION (CPR)!!!!
7. Know what bradycardia looks like on monitor and the treatment
8. Know Signs and symptoms of left sided heart failure and right sided heart
failure
LEFT SIDED HEART FAILURE
-Cause for left sided heart failure include mitral and aortic valve disease, coronary artery
disease and hypertension.
-Orthopnea, coughing, and difficulty breathing could all be results of left sided heart
failure, as well as dyspnea on exertion!!
-Client may report weakness and fatigue while performing activities of daily living as well
as difficulty breathing and catching their breath. EX. walking up the stairs.
- The presence of an S3 gallop is an early diastolic filling sound indicative of increasing
left ventricular pressure and left ventricular failure.
RIGHT SIDED HEART FAILURE
NUR2571: Professional Nursing II / PN 2 Exam 2 Study Guide
1. Effects of beta-blockers on heart and heart rate
-Beta Blocker will decrease Heart Rate and Blood pressure.
-Assess heart rate (HR) and blood pressure (BP) before administration because beta
blockers cause a decrease in HR and cardiac output and suppress renin activity.
• Do not administer if HR is <50-60 beats/min.
• Hold for systolic <90-100 mm HG and contact the health care provider.
• Monitor for orthostatic hypotension because this is a common adverse effect that can
contribute to falls and confusion, especially in older adults.
- Use with caution in patients with diabetes because glucose production may be affected.
- Teach the patient that these agents can cause fatigue, depression, and sexual
dysfunction. These adverse effects should be reported to the primary health care
provider.
2. Complications of atrial fibrillation
-Atrial fibrillation occurs commonly in clients with cardiac disease and is a common
reoccurrence after coronary artery bypass graft surgery.
-Clients are at risk for embolitic stroke. Evidence of embolitic events includes changes I
mentation, speech, sensory function, and motor function.
-Clients with A-fib often have a rapid ventricular response as a result.
- Clients with a-fib are at risk for decreased cardiac output and fatigue when completing
activities of daily living.
-Nursing Intervention: schedule periods of rest and exercise during the day.
-for patients with acute a-fib who have a cardioversion, the nurse should turn off
any oxygen therapy to prevent fire.
3. Complications from wide QRS and bradycardia combined, what does it
mean?
-An HR of 40 beats/min or less with widened QRS complexes could have hemodynamic
consequences. The client is at risk for inadequate cerebral perfusion. The nurse should
assess for level of consciousness, lightheadedness, confusion, syncope and seizure
activity.
4. What does pacer spikes without QRS complex imply and what
complication can it cause?
-Pacer spike without QRS complex imply “LOSS OF CAPTURE”. If there is no capture then
there is no ventricular depolarization and contraction. The nurse should assess for
cardiac output via vital signs and level of consciousness.
5. Precautions taken when the nurse uses a defibrillator
, 2
-PRIORITY: Ensure that everyone is clear of contact with the client and the bed**
-Epinephrine should be administered AFTER defibrillation
6. Know what V-Tach looks like on monitor and the treatment
-You MUST shock someone with ventricular tachycardia via defibrillator AND INITIATE
CARDIO-PULMONARY RESUSCITATION (CPR)!!!!
7. Know what bradycardia looks like on monitor and the treatment
8. Know Signs and symptoms of left sided heart failure and right sided heart
failure
LEFT SIDED HEART FAILURE
-Cause for left sided heart failure include mitral and aortic valve disease, coronary artery
disease and hypertension.
-Orthopnea, coughing, and difficulty breathing could all be results of left sided heart
failure, as well as dyspnea on exertion!!
-Client may report weakness and fatigue while performing activities of daily living as well
as difficulty breathing and catching their breath. EX. walking up the stairs.
- The presence of an S3 gallop is an early diastolic filling sound indicative of increasing
left ventricular pressure and left ventricular failure.
RIGHT SIDED HEART FAILURE
