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Perfusion Exam > Class 1 > Flashcards

Class 1 Flashcards

1
Q

major pacemaker of the heart

A

sinoatrial node

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2
Q

intrinsic rate of SA node

A

60-100 bpm

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3
Q

second to take over if SA node fails as pacemaker

A

atrioventricular node

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4
Q

intrinsic rate of AV node

A

40-60 bpm

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5
Q

third to take over if SA node and AV node fail as pacemaker

A

purkinje fibers

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6
Q

intrinsic rate of purkinje fibers

A

30-40 bpm

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7
Q

in a 3rd degree AV block, what is the expected HR

A

30-40 bpm

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8
Q

what is the J point

A

where the S wave comes back to the isoelectric line

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9
Q

isoelectric line AKA

A

baseline

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10
Q

T or F: at the isoelectric line there is no electrical current flowing

A

true

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11
Q

should the Q wave be above or below the isoelectric line

A

below

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12
Q

should the R wave be above or below the isoelectric line

A

above

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13
Q

the S wave must do this

A

return to the isoelectric line

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14
Q

where is the normal ST segment

A

at the isoelectric line

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15
Q

should the T wave be above or below the isoelectric line

A

above

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16
Q

a low/flat T wave can indicate what

A

ischemia

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17
Q

a peaked T wave can indicate what

A

high potassium

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18
Q

a visible U wave can indicate what

A

low potassium

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19
Q

according to the AHA, how long do you have to intervene after an EKG shows an elevated or depressed ST segment

A

30 mins

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20
Q

a deep or wide Q wave can indicate what

A

necrosis/MI

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21
Q

what does a notch in the R wave indicate

A

bundle branch block

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22
Q

largest muscle in heart

A

left vent

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23
Q

pacing spike

A

pacemaker has discharged an electrical impulse

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24
Q

capture (pacemaker)

A

pacemaker has successfully depolarized the chamber

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25
Q

asynchronous/fixed (pacemaker)

A

pacemaker not programmed to sense intrinsic electrical activity

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26
Q

synchronous/demand (pacemaker)

A

pacemaker programmed to sense intrinsic electrical activity

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27
Q

this type of pacemaker is not programmed to fire unless electrical activity is not sensed

A

synchronous/demand

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28
Q

this type of pacemaker fire’s when it is programmed even if it does not need to fire based off of the intrinsic electrical activity

A

asynchronous/fixed

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29
Q

type of pacemaker that is across the skin and can cause painful electric shocks

A

transcutaneous

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30
Q

T or F: the nurse should wear gloves when caring for a patient with a transcutaneous pacemaker

A

TRUE

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31
Q

with this type of pacemaker BP should be taken only in the R arm or lower extremity and pulses may need to be taken with the carotid artery

A

transcutaneous

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32
Q

this type of pacemaker is used only in an emergency situation for someone who does not have an implanted pacemaker

A

transcutaneous

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33
Q

this type of pacemaker is threaded through an vein similar to a central line and goes into an artery in the heart

A

epicardial

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34
Q

pacemaker that has a probe attached to the heart during surgery

A

epicardial

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35
Q

important for positioning pt with endocardial pacemaker

A

HOB not too high

keep legs straight (if inserted in femoral)

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36
Q

you must assess for this after the placement of a permanent pacemaker

A

pneumothorax

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37
Q

type of pacemaker that is placed for recurrent/chronic dysrhythmias

A

permanent

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38
Q

holter monitor

A

can be worn at home and data can be looked at in office at any time

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39
Q

telemetry monitor

A

in hospital monitoring, no monitor in room, someone looks at screen outside of room

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40
Q

cardiac monitor

A

monitor is in the pts room

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41
Q

indicators of a pacemaker malfunction

A

pacing at inappropriate rate

s/s that were present prior to pacemaker placement

42
Q

issue when pacemaker fires an impulse but the myocardium does not depolarize

A

failure to capture

43
Q

issue when pacemaker fails to sense P wave or QRS complex

A

undersensing

44
Q

which pacemaker issue can result in overpacing

A

undersensing

45
Q

issue when pacemaker sense other electrical activity as a P wave or QRS complex

A

oversensing

46
Q

which pacemaker issue can result in underpacing

A

oversensing

47
Q

what can cause a pacemaker to oversense

A

increased potassium

48
Q

normal appearance of QRS complex

A

peaked

49
Q

normal appearance of P wave

A

rounded, upright

50
Q

normal duration of PR interval

A

0.12-0.20

51
Q

normal duration of QRS complex

A

0.12 or less

52
Q

what can an elevated or depressed ST segment indicate

A

injury to myocardium

53
Q

T or F: normal is no Q wave

A

TRUE

54
Q

a synchronized cardioversion is done when there is an issue with which wave

A

R wave

55
Q

what does a synchronized cardioversion do

A

depolarize myocardial cells

stop chaotic heart activity

56
Q

pt gets this due to dysrhythmia that requires emergent attention

A

implantable cardio defibrillator

57
Q

delivers a very strong shock that can cause pt to fall over, shake, etc

A

implantable cardio defibrillator

58
Q

pt should not drive until they know the effect the shock of this device has on them

A

implantable cardio defibrilator

59
Q

make sure there is a ___ for every QRS complex

A

P wave

60
Q

common causes of sinus bradycardia

A 
well conditioned athlete
vagal stim
decreased metabolic rate
heart disease
medications
61
Q

dysrhythmia in which the sinus node creates an impulse at a below normal rate

A

sinus bradycardia

62
Q

meds that can cause sinus bradycardia

A

amiodarone
beta blockers
CA channel blockers
digoxin

63
Q

interventions/meds to correct sinus bradycardia

A

atropine
pacing
dopamine
epinepherine

64
Q

dysrhythmia in which the PR interval is >0.20 seconds but all impulses are conducted to the ventricles

A

first degree AV block

65
Q

the PR interval is greater than normal in these dysrhythmias

A

AV block

66
Q

dysrhythmia in which the PR interval is progressively prolonged until the impulse is not conducted to the vents

A

second degree AV block type I

67
Q

dysrhythmia in which the PR interval is constant but not all impulses are conducted to the ventricles

A

second degree AV block type II

68
Q

dysrhythmia in which there is a complete block of all impulses to the ventricles

A

third degree AV block

69
Q

junctional rhythm

A

the AV node is the pacemaker instead of the SA node

70
Q

dysrhythmia in which the sinus node creates an impulse at a faster than normal rate

A

sinus tachycardia

71
Q

common causes of sinus tachycardia

A

increased sympathetic tone

increased metabolic demands (fever, exercise)

72
Q

interventions used to treat sinus tachycardia

A

indentify, correct, and eliminate underlying cause

73
Q

dysrhythmia in which an electrical impulse starts in the atrium before the next normal impulse of the SA node occurs

A

premature atrial contraction (PAC)

74
Q

dysrhythmia in which there is uncoordinated electrical activation that causes a rapid, disorganized twitching of the atrial muscles

A

a fib

75
Q

common causes of PAC and SVT

A

increased catecholamine levels
heart disease
caffeine

76
Q

interventions/meds used to treat PAC/SVT

A 
vagal maneuvers
synchronized cardioversion
adenosine
beta blockers
CA channel blockers
77
Q

T or F: in supraventricular tachycardia, there is an abnormal QRS complex

A

false, the QRS complex is normal

78
Q

risk when giving adenosine

A

can cause absent HR for around 2 mins

can cause bronchospasm

79
Q

pts with these issues should not be given adenosine

A

asthma

COPD

80
Q

have this ready when giving adenosine

A

crash cart

81
Q

common causes of a-fib/flutter

A

advanced age

heart disease

82
Q

interventions/meds used to treat a fib/flutter

A 
vagal maneuvers
synchronized cardioversion
beta blockers
CA channel blockers
if HF present: amiodarone and digoxin
83
Q

these meds are used to treat a-fib/flutter only if HF is present

A

amiodarone

digoxin

84
Q

more than 3 PVCs in a row

A

v tach

85
Q

2 areas of the ventricle with abnormal activity

A

PVCs

86
Q

common causes of PVCs

A

electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires

87
Q

what can happen as a result of frequent PVCs

A

decreased cardiac output leading to v tach/v fib

88
Q

interventions used to treat PVCs

A

search for possible reversible causes

89
Q

common causes of v tach

A

electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires

90
Q

interventions used to treat v tach w/ pulse

A 
synchronized cardioversion (only for monomorphic)
amiodarone 
lidocaine
pronestyl
sotalol
91
Q

tx for polymorphic v tach

A

defibrillation

92
Q

interventions used to treat v tach w/ no pulse

A 
PT IS IN CARDIAC ARREST
CPR
defibrillation
epinepherine
amiodarone
lidocaine
93
Q

dysrhythmia in which there is a rapid disorganized ventricular rhythm that causes ineffective quivering of the ventricles and no atrial activity

A

v fib

94
Q

common causes of v fib

A

electrolyte disturbances
hypoxia
mechanical irritation of myocardium with catheters/wires

95
Q

interventions used to treat v fib

A 
PT IS IN CARDIAC ARREST
CPR
defibrillation
epinepherine
amiodarone
lidocaine
96
Q

dysrhythmia in which there is an absent QRS complex confirmed by 2 leads

A

asystole

97
Q

interventions used to treat asystole

A

PT IS IN CARDIAC ARREST
CPR
epinepherine
ID and treat reversible causes

98
Q

dysrhythmias in which the pt is in cardiac arrest

A

asystole
v fib
v tach w/ no pulse

99
Q

examples of pulses electrical activity

A

pericarditis

cardiac tamponade

100
Q

s/s of cardiac tamponade

A

SOB
muffled heart sounds
JVD
pulsus paradoxus

101
Q

T or F: you should shock a pt with asystole and a pulseless electrical activity

A

false

Perfusion Exam (3 decks)

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