NUR440 EXAM 1 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED UPDATE GRADED A 2025/2026

NUR440 EXAM 1 QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED UPDATE GRADED A 2025/2026 Terms in this set (153) -Slow rate = 60 bpm -Regular rhythm = P before every QRS -PR interval = 0.12 to 0.20 seconds -QRS complex = 0.12 seconds Causes: 1. Genetics 2. MI 3. Sleep apnea 4. ↑ ICP 5. ↓ Metabolic needs (anorexia) 6. ↑ Exercise tolerance 7. HYPOthyroidism 8. Vagus nerve stimulation (coughing, grunting, straining for BM) 9. Normal aging 10. Prolonged hypoxia 11. Infection: Lyme disease; Typhoid fever; Malaria; Rocky mountain fever Manifestations: s/s of ↓CO *Can be asymptomatic or symptomatic 1. Dizziness 2. Chest pain 3. Near syncope 4. Mental status changes/ altered LOC 5. SOB Cardiovascular Cardiac Arrhythmias: Cardiac Rhythms: Sinus Bradycardia LABS: 1. Electrolytes -Hypermagnesemia (↓ heart's electrical activity) -Hypercalcemia (↓ excitability of cardiac cells) -Hyperkalemia (impairs electrical conduction system) 2. Thyroid panel = HYPOthyroidism 3. Troponin = for cardiac injury 4. Blood & urine for toxicology = drug use? Treatment: 1. Is pt unstable or stable? 2. Monitor VS 3. Monitor ECG 4. Administer fluids via IV (saline-locked) 5. Prepare for pacemaker (to ↑ HR for adequate perfusion) Nursing Care: 1. FALL PRECAUTIONS r/t low HR 2. Identify the cause 3. Instruct pt on lifestyle changes to ↓ potential injury 4. Observe asymptomatic pts 5. Unstable pts: -IV atropine 1 mg (to ↑ HR); repeat 3-5 mins; DO NOT exceed total 3 mg -Temporary transcutaneous pacemaker if pt continues to remain unstable and symptomatic GOAL: 1. Stabilize HR over 60 bpm 2. Continuous cardiac monitoring for improvement Cardiovascular Cardiac Arrhythmias: Cardiac Rhythms: Atrial Fibrillation (Afib) (1/2) 1. What is it? 2. Pathophysiology 3. Causes 4. Manifestations -Fast rate = 100 bpm -Irregular rhythm -P waves not present & replaced with fibrillatory waves -PR interval = not discernable -QRS complex = narrow, 0.12 seconds Pathophysiology: -When SA node is NOT firing appropriately & electrical impulses become rapid, chaotic, & irregular -DOES NOT allow for effective contracting of atria & BF into ventricles -LEADS TO: ↓ CO (r/t ineffective & irregular contractions) and blood clots (r/t irregularity of BF OUT OF ventricles) Causes: 1. HTN 2. CHF 3. DM 4. Hx uncontrolled blood glucose 5. Obesity ( 60 yrs) 6. COPD 7. Thyroid disease 8. Kidney disease 9. Stroke 10. HYPERthyroidism 11. Obstructive sleep apnea Manifestations: s/s of ↓ CO *May interfere with pt's ability to perform ADLs *Can be asymptomatic or symptomatic 1. Irregular pulse 2. HYPOtension 3. Heart palpitations ("pounding" "racing") 4. Increased HR 5. Chest discomfort 6. SOB 7. Exertional fatigue 8. Anxiety 9. Dizziness/ Lightheadedness 10. Syncope (r/t ↓ O2 to brain) 11. Weight gain 12. Increased urination