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MS II Prep U Ch. 26: Management of Patients With Dysrhythmias and Conduction Problems

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MS II Prep U Ch. 26: Management of Patients With Dysrhythmias and Conduction Problems A home care nurse is visiting a left-handed client who has an implantable cardioverter-defibrillator (ICD) implanted in his left chest. The client tells the nurse how excited he is because he's planning to go rifle hunting with his grandson. How should the nurse respond? "Enjoy your time with your grandson." "You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site." "Being that close to a rifle might make your ICD fire." "You'll need to take an extra dose of your antiarrhythmic before you shoot." "You can't shoot a rifle left-handed because the rifle's recoil will traumatize the ICD site." The recoil from the rifle can damage the ICD, so the client should be warned against shooting a rifle with his left hand. Close proximity to a rifle won't cause the ICD to fire inadvertently. The client shouldn't take an extra dose of his antiarrhythmic. A nursing student is giving to a client with heart failure a medication with a positive inotropic effect on the heart. The student asks what a "positive inotropic" effect is. The correct response would be which of the following? It increases the force of the myocardial contraction. It increases the heart rate. It increases the respiratory rate. It causes the kidneys to retain fluid and increase intravascular volume. It increases the force of the myocardial contraction. A positive inotropic effect increases the force of myocardial contraction. A positive chronotropic effect increases the heart rate. A positive inotropic effect will usually help slow respiratory rate and will increase blood flow through the kidneys, so fluid output will increase. A nurse and nursing student are caring for a client with coronary heart disease and providing information about the disease process to the client. When client care is completed, the student asks the nurse what things stimulate the heart to beat faster. The correct response would be which of the following? "Anything that stimulates the sympathetic nervous systerm (positive chronotropy)"

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Voorbeeld van de inhoud

Nurse 113 Exam 1
language deficits

Sensory deficits

Cognitive impairments
Identify impairments of communication
Verbal and Nonverbal
When considering culture, what are the two forms of communication that you use?
Hunger

Pain

Shortness of breath

Nausea

Noise level
List four factors that relate physical, emotional and environmental factors:
Problems:
Impaired communication
Anxiety
Powerlessness
Impaired social interaction
Social isolation
Situational low self-esteem
Ineffective coping
Defining characteristics:
difficulty forming words
inability to articulate words
Lacking skills in attending listening, or self-expression
What are some nursing problem diagnosis?
1) Nurse and patient set goals and determine expected outcomes

2) Set priorities

3) Utilize teamwork and collaboration
List the Nursing Planning Process
Utilize therapeutic communication techniques during the patient interview

Adjust the environment

Provide Support

,Employ measures to enhance communication

Educate the patient and family
Name the Nurse Process Implementations:
The nurse and patient determine if goals and expected outcomes have been met

Evaluate if nursing interventions were effective

If expected outcomes are not met, modify the plan of care
Nursing Process Evaluation:
Preinteraction Phase: Before meeting the patient

Introductory Phase: When the nurse and patient meet for the first time; sets the
tone for the rest of the relationship

Working: When the nurse and patient work together to meet pre-established
goals

Termination Phase: The relationship ends
What are the four phases in the relationship table?
True
Active listening means being attentive to what a patient is saying both verbally and
nonverbally (T/F)
Squarely face the patient

Open Posture

Lean toward the patient

Eye contact

Relax
What are some therapeutic physical communication techniques?

List five:
Clarification
Restating an unclear or ambiguous message(paraphrase); ask other person to restate
by explaining further by giving an example means what?

What are you seeking?
Offering Self (therapeutic)
Displaying interest and caring means you're doing what?
Giving information (therapeutic)
Helping the patient make decisions, experience less anxiety, feel safe and secure in
health education contribute to what?
Therapeutic

, Sharing empathy, focusing on key on concepts, self-disclosure, asking relevant
questions, one question at a time, fully exploring a topic before moving on is what type
of technique?
Probing

Asking for explanations

Changing subject

Stereotyping

Being judgmental

Unwarranted reassurance

Being defensive

Arguing
List some barriers of communcation:
Probing
Asking irrelevant questions is known as?
time, place, seating arrangement, distance, language
Planning interview constitutes to:
Observe - Notice, select, organize, interpret, vision, smell, hearing, touch

Listen

Ask Questions

Mentally Retain Information
Collecting data by:
open-ended questions
What type of questions invites the patient to elaborate and illustrate their thoughts and
feelings?
close-ended questions
What type of question limits answers to one or two words?
Neutral questions
Patients that can answer without direction or pressure are known as what type of
questions?
Leading questions
What suggests an answer to the patient? This is hard for the patient to not only agree
but it is also considered non-therapeutic.
True
Inconsistency in team membership, lack of time, hierarchy, defensiveness and conflict
are barriers of team performance. (T/F)

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