It’s Not You, It’s Your Symptoms
A patient reports shortness of breath with activity, has oxygen saturation of 89%, and uses accessory muscles to breathe.
Impaired Gas Exchange
You see an irregularly irregular rhythm with no identifiable P waves and a narrow QRS
Atrial Fibrillation or AFib
Insulin used for coverage in a sliding scale and has an onset of action of about 15 minutes.
Rapid-acting insulin (lispro or aspart)
Your patient receiving IV antibiotics suddenly develops hives, facial swelling, wheezing, and hypotension. This condition can lead to airway obstruction and cardiovascular collapse within minutes.
Anaphylactic Shock
A client recovering from abdominal surgery suddenly reports feeling like something “popped” in their incision. Upon inspection, you see bowel protruding. This is your first action.
Cover the wound with sterile saline-soaked gauze and notify the provider?
A post-op patient has not voided in 8 hours, has bladder distension, and is restless.
Urinary Retention
This bradyarrhythmia features a progressively lengthening PR interval followed by a dropped QRS complex.
Second-degree AV block type I (Mobitz I or Wenckebach)
What is Metoprolol and what assessments would you preform before and after administration?
Beta blocker.
Assess BP and HR
Electrolyte imbalance, often seen in renal failure or after massive cell destruction, can cause fatal heart arrhythmias if not corrected immediately.
Hyperkalemia
A client taking warfarin who states “I’ll take aspirin for my headaches” needs this type of nursing intervention.
Re-education about drug interactions and bleeding risk
Patient has bilateral crackles in the lungs, +3 pitting edema in BLE, and dyspnea when lying flat.
CHF Exacerbation
This rhythm features a wide QRS complex with no preceding P waves and can quickly become life-threatening.
Ventricular Tachycardia
IV diuretic commonly given to reduce fluid overload in patients with acute heart failure and requires close monitoring of potassium levels.
Furosemide (Lasix)
Condition is a life-threatening complication of central line placement that can present with sudden shortness of breath, hypotension, and tracheal deviation.
Tension Pneumothorax
Your patient receiving IV morphine becomes difficult to arouse, with a respiratory rate of 7. This is your first nursing action.
1:Stop the medication
2: Assess airway/breathing
A middle-aged client with diabetes has a non-healing foot ulcer, decreased peripheral pulses, and cool skin.
Ineffective Peripheral Tissue Perfusion
This rhythm is characterized by a ventricular rate >150 bpm, regular rhythm, and no visible P waves — often described as a “shark tooth” pattern.
Supraventricular tachycardia (SVT)
Anticoagulant requires monitoring of aPTT and is often reversed with protamine sulfate
Heparin
Your post-op patient reports "impending doom," chest pain, and shortness of breath. Minutes later, they become hypotensive and tachycardic.
Pulmonary Embolism
A nurse is assessing a post-op client who is 14 hours post-surgery, reports calf pain, and has a swollen, red leg. This is the nurse’s next priority action.
Notify the provider due to risk of DVT?
A patient who is NPO reports dry mouth, cracked lips, and concentrated urine output.
What is Deficient fluid volume?
There is no relationship between P waves and QRS complexes, and the atrial and ventricular rates are independent.
3rd Degree or Complete Heart Block
Oral opioid analgesic often used for moderate to severe pain management. Combined with acetaminophen in some formulations; nurses must monitor for respiratory depression and liver toxicity.
Hydrocodone-acetaminophen (e.g., Norco)
Post-operative abdominal surgery patient has new-onset tachycardia, hypotension, fever, and a rigid, distended abdomen. This surgical emergency can result in septic shock if not treated immediately.
Bowel Perforation with Peritonitis
A nurse is triaging four clients in the ED. The client with this condition should be seen first:
A. Epigastric pain after spicy food
B. Severe abdominal pain and rigid abdomen
C. Painful urination with fever
D. A nosebleed that stopped 15 minutes ago
B. Severe abdominal pain and rigid abdomen?