Ch. 7: Technology Flashcards
Your ICU patient has ARDS with a PaO2 of 62 mmHg despite mechanical ventilation and oxygenation. What explains this finding?
a problem with gas diffusion in the lung
the most important factor in determining the respiratory rate is:
arterial pCO2
Hot, pale, dry skinned patient with rhonchi and rales throughout the left lung with clear right lung sounds. HR 134, BP 88/64, RR 24, and SaO2 92%. Hx of 2 previous MIs and takes nitro PRN. What is best prehospital management?
oxygen via NRB and IV of NS with fluid challenge
ETCO2 is recorded during which phase of the capnogram?
III
Your patient is a 15 y/o asthmatic having dyspnea for 45 minutes but does not have his inhaler. Capnography shows an ETCO2 of 45 mmHg. How can you interpret this finding?
The patient;s ETCO2 first dropped as he began to hyperventilate but now is rising again and may continue to rise to dangerous levels
A CO-oximeter displays an SpCO of 15%. What is the most appropriate interpretation of this finding?
consistent with mild CO poisoning
A male patient with an acute exacerbation of his emphysema presents in severe distress with decreased air movement and diffuse inspiratory wheezes in all fields. HR 132, BP 142/88, RR 30, SaO2 88%. What blood gas value is likely?
pCO2 of 70
Patient unconscious and apneic on a garage floor with a running car and closed door. HR 70, BP 100/60, RR 0. In addition to an IV of NS, what should you do?
remove the patient from the garage, initiate BVM ventilations with 100% O2, intubate and transport to a hospital with a hyperbaric chamber
What statement about pulse oximetry is FALSE?
pulse oximetry values can be expected to decrease within seconds in cases of developing hypoxia
What would result in an increased respiratory rate?
stimulation of chemoreceptors by an increase of PCO2
blood entering the left atrium arrives via the:
pulmonary vein
the presence of inverted T waves on an ECG indicates:
myocardial ischemia
when the ECG paper is traveling at the standard rate of 25 mm/sec, a large box in the horizontal direction equals:
0.20 seconds
Which endocrine substance acts as a marker for CHF?
BNP
the total duration of ventricular depolarization is represented by the ______ on the ECG
QRS duration
the anterior surface of the heart is best viewed by ECG leads:
V1-V4
an ECG monitor is useful for:
evaluating the heart’s electrical conduction system for abnormalities
Which ECG finding is LEAST anticipated in a patient experiencing an acute MI?
osborn wave
Your patient is a 73 y.o male who is in a recliner, cyanotic, pulseless and apneic. His skin is cool and dry. His wife last saw him an hour and a half ago. What should you do first?
check for rigor mortis
the lead to the left of the sternum at the fourth intercostal space is:
V2
the mitral valve is also known as the ________ valve
left atrioventricular
A 12-lead ECG that reveals slight ST elevation; Q waves in leads II, III and aVF; and ST elevation in V1 and V2 most indicate:
MI in inferior wall and ischemia extending into the right ventricle
an elevation of the ST segment is associated with:
myocardial injury
What is the LEAST urgent when evaluating a patient suspected of suffering an acute MI?
NOT breath sounds or ECG… pulse oximetry or BP??
What is NOT a traumatic mechanism by which a myocardial injury can be produced?
traumatic brain injury
What can be determined by lead II cardiac monitoring?
impulse conduction time
what best characterizes successful defibrillation?
uniform mass depolarization of myocardial cells, repolarization, intrinsic pacemaker function resumes
at standard speed a 1 mm box on ECG paper represents ______ seconds
0.04
artifacts can make assessment of a paced rhythm difficult because:
an artifact can obscure the pacer spikes
what artery supplies blood to the left ventricle, interventricular septum, and portions of the cardiac conduction system?
left coronary artery
the precordial leads provide a view of the:
horizontal plane of the heart, including the left ventricle and septum
what is the ability of a cardiac cell to propagate the electrical impulse to another cell?
conductivity
A patient that has SpMet readings of 40% would be expected to have signs and symptoms of methemoglobinemia, such as:
headache, dyspnea, confusion, weakness, and chest pain
What cells released from the Islets of Langerhans produce glucagon, which increase blood glucose levels?
alpha cells
What cells produce somatostatin, which inhibits the production of glucagon and insulin?
delta cells
What cardiac enzyme and biomaker is NOT measured and analyzed to help confirm a MI?
B-natriuretic peptide (BNP)
