what are the ecg changes seen with hyperkalemia
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Nursing Elites

ATI RN

ATI Capstone Adult Medical Surgical Assessment 2

1. What ECG changes are seen with hyperkalemia?

Correct answer: A

Rationale: Flattened T waves are an early ECG sign of hyperkalemia. Hyperkalemia affects the repolarization phase of the cardiac action potential, leading to changes such as peaked T waves, prolonged PR interval, widened QRS complex, and ultimately sine wave pattern. Elevated ST segments, prominent U waves, and widened QRS complex are not typically associated with hyperkalemia, making choices B, C, and D incorrect.

2. What is the purpose of an escharotomy in burn management?

Correct answer: A

Rationale: An escharotomy is performed to relieve pressure in areas affected by deep burns and improve circulation. This procedure involves making incisions through the eschar (burned and dead tissue) to release constricting tissue and allow for the return of blood flow. Choice B is incorrect because the removal of necrotic tissue is typically done through debridement, not escharotomy. Choice C is incorrect because preventing infection in burn injuries is usually achieved through proper wound care and antibiotic therapy, not escharotomy. Choice D is incorrect because removing excess fluid from burn wounds is managed through methods like fluid resuscitation and monitoring, not escharotomy.

3. What is the primary nursing action for a patient experiencing continuous bubbling in the chest tube water seal chamber?

Correct answer: A

Rationale: The correct answer is to tighten the connections of the chest tube system. Continuous bubbling in the chest tube water seal chamber indicates an air leak. By tightening the connections of the chest tube system, the nurse can often resolve the issue by ensuring there are no loose connections allowing air to enter. Clamping the chest tube or replacing the chest tube system are not appropriate actions in this situation. Clamping the tube can cause a dangerous buildup of pressure, while replacing the system should only be considered if tightening the connections does not resolve the air leak.

4. What is the preferred electrical intervention for a patient with ventricular tachycardia with a pulse?

Correct answer: B

Rationale: Synchronized cardioversion is the preferred electrical intervention for ventricular tachycardia with a pulse. In this scenario, the heart still has an organized rhythm, so synchronized cardioversion is used to deliver a shock at a specific point in the cardiac cycle, aiming to restore a normal rhythm. Defibrillation (Choice A) is used for pulseless ventricular tachycardia or ventricular fibrillation. Pacing (Choice C) may be used for bradycardias or certain types of heart blocks. Medication administration (Choice D) can be considered for stable ventricular tachycardia, but synchronized cardioversion is the primary intervention for ventricular tachycardia with a pulse.

5. After a healthcare provider misreads a glucose level and administers insulin, what is the priority intervention?

Correct answer: A

Rationale: The correct answer is to monitor for hypoglycemia. Administering insulin based on a misread glucose level can lead to hypoglycemia. Monitoring for hypoglycemia is crucial as it is a potential adverse effect of the insulin administration. Administering glucose IV (Choice B) is not the priority as there is no indication of hypoglycemia yet. Documenting the incident (Choice C) is important but not the immediate priority over patient safety. Monitoring for hyperglycemia (Choice D) is not the priority after administering insulin in response to a misread glucose level.

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