Page 1683 - Saunders Comprehensive Review For NCLEX-RN

pulse increases more than 10 beats per
minute.
l. Monitor episodes of pain closely.
m. See Box 52-2 for home care
instructions.
G. Heart transplantation
1. A donor heart from an individual with a comparable
body weight and ABO compatibility is transplanted
into a recipient within less than 6 hours of
procurement.
2. The surgeon removes the diseased heart, leaving the
posterior portion of the atria to serve as an anchor for
the new heart.
3. Because a remnant of the client’s atria remains, 2
unrelated P waves are noted on the ECG.
4. The transplanted heart is denervated and
unresponsive to vagal stimulation; because the heart
is denervated, clients do not experience angina.
5. Symptoms of heart rejection include hypotension,
dysrhythmias, weakness, fatigue, and dizziness.
6. Endomyocardial biopsies are performed at regularly
scheduled intervals and whenever rejection is
suspected.
7. The client requires lifetime immunosuppressive
therapy.
8. Strict aseptic technique and vigilant hand washing
must be maintained when caring for the
posttransplantation client because of increased risk
for infection from immunosuppression.
9. The heart rate approximates 100 beats per minute and
responds slowly to exercise or stress with regard to
increases in heart rate, contractility, and cardiac
output.
IV. Cardiac Dysrhythmias

A. Normal sinus rhythm (Fig. 52-5)

1. Rhythm originates from the SA node.
2. Description
a. Atrial and ventricular rhythms are
regular.
b. Atrial and ventricular rates are 60 to
100 beats per minute (Fig. 52-6 and Box
52-3).
c. PR interval and QRS width are within
normal limits.
B. Sinus bradycardia
1. Description
a. Atrial and ventricular rhythms are

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