Case Study IV


Mr. T, a 62 year old male, is admitted to the ER complaining of chest pain. At this moment he is pain free.

Physical Assessment:

Neuro: Sleepy, but rouses easily to voice. AAOx3. Exhibits equal strength in all extremities.
Pulmonary: Lungs are clear. Resp. even and unlabored. Mr. T. is on O2 via nasal cannula at 2L/min.
GI: Bowel sounds normal, abdomen soft and nontender.
GU: Voiding clear yellow urine without problems.
CV: Heart sounds normal with S1 and S2 present. Nail beds pink with good capillary refill. Denies chest pain at this moment.

Vitals: HR: 60, BP 102/55, Resp. 16, Temp. 97.2 F, Height 6’0", Weight 210 lb.

History:
Mr. T. is a construction worker and states he is active and normally healthy. He has been having episodes of chest pain for the past 3 months, but thought it was just "gas" and didn’t go his physician. Mr. T. is a past smoker and has been cigarette free for the past 12 months. He states he had "a few beers with his buddies after work".
Medications: Tums 2 tabs prn prior to this admission.
Diagnostic Studies:

Questions: (IMPORTANT! See instructions below*)

 

1. What is the above rhythm?
1st degree AV block
2nd degree AV block type I
2nd degree AV block type II
3rd degree AV block

 

2. Treatment for Mr. T. might include;
Emergent pacemaker
Lidocaine
Nitroglycerine
None of the above


3. This rhythm is caused by which of the following?
Some impulses do not induce a ventricular response.
All atrial impulses are blocked.
The heart can't repolarize
The ventricles aren't fully contracting.


4. This rhythm is:
Always fatal
Normal
Often accompanies inferior MI
Requires a pacemaker

 

5. Nursing care for Mr. T includes:
EKG monitoring
Treating his chest pain
Relieving his anxiety
All of the above


The basic dysrhythmia course that is recommended as background for this Cardiac Case Studies course is the RnCeus.com course:

EKG Strip Indentification and Evaluation


*IMPORTANT!

Please write down and save your answers to the above questions. The questions will be repeated on the "Exam and Evaluation", but the scenarios and strips will not be repeated.


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