Calcium channel blockers, such as amlodipine cause side effects that affect the conduction of the heart. Other side effects include nausea, headache, rash, and gingival hyperplasia. 

Thrombolytic therapy is commonly given to patients who have strokes to dissolve clots. This therapy is contraindicated in people who have recently had surgery due to the risk for hemorrhage. It is also contraindicated in currently pregnant women. Ibuprofen and beta blockers are not contraindications to thrombolytic therapy. Cardiac dysrhythmias are also not contraindicated with thrombolytic therapy.

Ventricular fibrillation is a potentially lethal rhythm. It is treated via defibrillation. This is an electrical shock that temporarily stops the heart in an attempt to have the natural pacemaker rhythm of the heart take over. Electrical therapy via defibrillation is the appropriate management of ventricular fibrillation.

Congestive heart failure tends to be precipitated by hypertension, type II diabetes, nutritional deficiencies such as thiamine, pulmonary disease, and chronic stress. Atrial fibrillation is not generally a causative factor in congestive heart failure, but these conditions are frequently seen together as they share an etiology. Vestibular irregularities are not generally observed in congestive heart failure.

The client describes pain at rest without a history of heart disease. This type of chest pain often describes prinzmetal's angina which is a spasm of a major coronary artery and can occur while at rest. Many times the client may have a history of other vasospastic conditions such as Raynaud's. It may be treated with a calcium channel blocker or nitrates. 

The first nursing action for a patient arriving in distress to the emergency department is always to begin with priority assessments including vital signs. It provides a baseline for the healthcare team to use when further assessment and treatment is implemented. An electrocardiogram may be used later but is not a priority action, and is ordered by the primary care provider and not the nurse. A thorough medical history and physical assessment will be useful but is not the first action the nurse must take. The physician should be notified but the nurse must assess vital signs first.

aVF is the main lead that points to the base of the heart (inferiorly). ST segment elevations in this lead help localize the area of infarction and can help identify the coronary artery involved. The precordial leads (V1-V6) do not point towards the base of the heart. Lead I is considered a lateral lead.

Hypertension is an incurable condition, and can be controlled by various interventions. Sodium should be redced but not eliminated, and blood pressure taken by the patient should be performed once daily then weekly after blood pressure has stabilized. Patient should be encouraged to report serious side effects to the physician before stopping the medications. Optimal times to take medications are on a regular basis, not after warm baths, alcohol ingestion, or strenous exercise. 

This is a normal finding, the QRS should have a duration between 0.6-0.12 seconds.