CCRN Arrhythmia Emergencies, Aneurysms. Cardiac Tamponade

Question 1

Why are prolonged QTs dangerous?

Answer 1

It may lead to tornadoes de pointes

Question 2

what may be causes of prolonged QT?

Answer 2

Drugs: quinidine, halloo, procainamide etc
electrolytes: low K, low Ca, low Mg

Question 3

Tx for torsades VT?

Answer 3

Mg IV

Question 4

3 basic pacer malfunctions?

Answer 4

1. Failure to pace
2. Failure to capture
3. Failure to sense

Question 5

What does failure to pace look like?

Answer 5

No spike at all when expected

Question 6

What does failure to capture look like?

Answer 6

spikes w/o QRS for ventricular pacing

Question 7

What does failure to sense look like?

Answer 7

Pacing in native beats

Question 8

Aneurysm Etiologies (8)

Answer 8

atherosclerosis, HTN, smoking, obesity, infections, congenital anomalies, trauma, Marfan’s syndrome

Question 9

Abdominal Aortic Aneurysm s/s (5)

Answer 9

asymptomatic if small, pulsation in the abdominal area, abdominal or low back pain, N.V, shock

reps 75% of all aneurysm

Question 10

Thoracic Aortic Aneurysm s/s (9)

Answer 10

sudden tearing, ripping pain in the chest that radiates to the shoulders, neck, back, cough, hoarseness, dysphagia, dyspnea, difficulty walking/speaking, widening of mediastinum

25% of all cardiac r/t aneurysms.

Question 11

How to tx aneurysms <5cm

Answer 11

Monitor regularly - U/S or CT

treat HTN- beta blocker

Question 12

How to tx thoracic aneurysm >6cm

Answer 12

surgery and blood pressure control.

IF DISSECTION, SURGERY and labetalol gtt

Question 13

What occurs during an aortic dissection

Answer 13

Blood passes through the inner lining and between layers of the aorta. Tear is pistol. Sudden. Asceding aorta.

Question 14

What occurs during cardiac tamponade?

Answer 14

Cardiac tamponade occurs when bleeding in pericardial sac causes compression to the heart.

Question 15

Cardiac Tamponade S/S? (6)

Answer 15

muffled heart tones, decreased BP, decreased CO, increased HR, SOB, decreased LOC, pulsus paradoxus.

Question 16

What occurs during pulses paradoxus?

Answer 16

Pulsus paradoxus is an inspiratory decline of systolic arterial pressure exceeding 10 mm Hg

Question 17

What are Beck’s Triad?

Answer 17

Hypotension, Muffled heart sounds, JVD

Question 18

Interventions for cardiac tamponade treatment?

Answer 18

periocardiocentesis, chest tube insertion, needle thoracotomy, surgical thoracotomy.

Maintain hemodynamic stability with fluid infusion, blood transfusion, vasopressors.