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ECG & Ventilation Flashcards

1
Q

What is normal sinus rhythm?

A

A normal beat that’s evenly spaced. There is no treatment; just continue to monitor. The cause is being very healthy.

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2
Q

What is bradycardia?

A

Bradycardia is a heart rate below 60 beats per minute.

Memory trick: The Brady Bunch for slower times.

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3
Q

What is the treatment for symptomatic bradycardia?

A

Atropine, but only if symptomatic, showing low perfusion like pale, cool, or clammy.

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4
Q

What causes bradycardia?

A

Typically from the vasovagal maneuver or medications that slow the heart rate, such as calcium channel blockers or beta blockers.

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5
Q

What is ventricular fibrillation (V fib)?

A

A rhythm where the heart is flopping around like a swiveling line.

Memory trick: VIB is flopping.

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6
Q

What is the primary treatment for V fib?

A

Defibrillation immediately; stop CPR and defibrillate before drugs.

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7
Q

What are the causes of ventricular fibrillation?

A

Untreated V tach, post MI, electrolyte imbalances, and proarrhythmic medications.

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8
Q

What is ventricular tachycardia (V tach)?

A

A rhythm characterized by a tombstone pattern.

Memory trick: V tach is for tombstone.

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9
Q

What are the treatments for V tach?

A

Early defibrillation, synchronized cardioversion if there is a pulse, and treat hypoxia.

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10
Q

What is atrial fibrillation (A fib)?

A

A rhythm with no P wave, indicating fibrillation.

Memory trick: No P wave means fibrillation.

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11
Q

What are the treatments for atrial fibrillation?

A

Cardioversion after ruling out clots, digoxin for deeper contraction, and anticoagulants like warfarin.

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12
Q

What is atrial flutter?

A

A rhythm with a sawtooth pattern.

Memory trick: A flutter has two T’s.

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13
Q

What is supraventricular tachycardia (SVT)?

A

A fast heart rate caused by stimulants, strenuous exercise, hypoxia, or heart disease.

Memory trick: Super fast for supraventricular.

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14
Q

What is the treatment for SVT?

A

Vagal maneuvers, adenosine, and cardioversion if necessary.

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15
Q

What is torsades de pointes?

A

A rhythm resembling a tornado of points, often caused by low magnesium.

Memory trick: Tornado of points.

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16
Q

What is asystole?

A

A flat line indicating the patient is flatlined.

Memory trick: Assist fully because the patient is flatlined.

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17
Q

What are the treatments for asystole?

A

Epinephrine, atropine, and CPR. No shock can be given as there is no electrical activity.

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18
Q

What does a key wave indicate?

A

An atrial rhythm.

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19
Q

What does a QRS complex indicate?

A

A ventricular rhythm.

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20
Q

What does chaotic or unorganized rhythm indicate?

A

Fibrillation.

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21
Q

What does bizarre rhythm indicate?

A

Tachycardia.

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22
Q

What does sawtooth rhythm indicate?

A

Atrial flutter.

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23
Q

What is mechanical ventilation?

A

Mechanical ventilation means that a machine is mechanically giving breaths or ventilations to a patient.

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24
Q

What is a ventilator?

A

The ventilator is the actual machine that works like an air pump, pumping air into the lungs.

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25
What is TPV?
TPV stands for positive pressure ventilation, which is different from normal breathing.
26
How does normal breathing differ from TPV?
In normal breathing, the lungs use negative pressure to bring in oxygen, while TPV uses positive pressure.
27
What is barotrauma?
Barotrauma is the trauma caused to the lungs from over inflation due to positive pressure ventilation.
28
What can happen in severe cases of barotrauma?
In severe cases, it can cause a pneumothorax, or a popped lung.
29
What is the risk associated with suctioning?
Suctioning can cause trauma, bleeding, and hypoxia, so it should only be performed when needed.
30
What is the first key point about suctioning?
We always suction out, never in.
31
What is the time limit for suctioning?
Suctioning should be done for ten seconds or less.
32
What should be done before suctioning?
Administer 100% oxygen thirty seconds before suctioning.
33
When should suctioning be avoided?
Avoid suctioning before ABG draws; wait at least twenty minutes.
34
What is a key term to remember about suctioning?
Avoid suctioning routinely due to the risk for acute lung injury.
35
What is VAP?
VAP stands for ventilator-associated pneumonia, a deadly infection inside the lungs.
36
What are two key actions to prevent VAP?
Reposition the patient side to side every two hours and perform oral care with chlorhexidine every two hours.
37
What are the best indicators of VAP?
A positive sputum culture, a fever over 100.4°F, and chest X-rays showing new infiltrates.
38
What interventions can prevent VAP?
Daily sedation and weaning protocols, elevating the head of the bed, oral care with chlorhexidine, and hand hygiene.
39
What should be avoided during NG tube feeding?
No bolus feedings due to increased risk for aspiration.
40
What is a complication associated with long-term mechanical ventilation?
GI stress ulcers from gastric secretions.
41
What should be given prophylactically to prevent GI ulcers?
Acid reducers like PPIs or H2 blockers.
42
What is the first action when O2 saturation drops?
Always assess lung sounds first.
43
What should be done if secretions are present?
Suction it out.
44
What bedside essentials should be available?
An extra intubation setup and a bag valve mask (ambu bag).
45
What is a pneumothorax?
A popped lung caused by barotrauma from excessive positive pressure.
46
What can cause hypotension in mechanically ventilated patients?
Positive pressure causing pressure on thoracic blood vessels, reducing cardiac output.
47
What should be done after extubation?
Use warm humidified oxygen via face mask and perform oral care with oral sponges.
48
What are the risks after extubation?
Atelectasis and pneumonia.
49
How can atelectasis be prevented?
Instruct the patient to use an incentive spirometer every hour.
50
What is stridor?
A noise heard upon inspiration indicating a narrow airway; it must be reported immediately.
51
What is the priority for a new tracheostomy?
Check the tightness of the ties to prevent dislodgement.
52
What should be done if a tracheostomy tube is dislodged?
Cover the stoma with a sterile occlusive dressing and ventilate the lungs with a bag valve mask.
53
What is the difference in managing a mature vs. new tracheostomy?
For a mature tracheostomy, insert a new tube; for a new tracheostomy, only cover the stoma and ventilate.
54
What is controlled mandatory ventilation used for?
It is used for clients with Guillain-Barré syndrome.
55
What effect does hyperventilation have on ICP?
It decreases carbon dioxide, which decreases ICP via vasoconstriction.
56
What are the two types of ventilator alarms?
Low pressure and high pressure alarms.
57
What does a low pressure alarm indicate?
It indicates a loss of connection resulting in an air leak.
58
What does a high pressure alarm indicate?
It indicates a blockage of airflow resulting in peaked airway pressure.
59
What is AC mode in mechanical ventilation?
Assist control mode, where the machine fully controls the patient's respiratory rate.
60
What is SIMV mode in mechanical ventilation?
Synchronized intermittent mandatory ventilation, where the patient mainly controls breathing and the machine assists.
61
What is tidal volume?
The volume of air delivered with each breath, typically 500 to 800 mls. ## Footnote Think of a tidal wave of air.
62
What does FRR stand for?
Frequency of respirations, or the number of breaths per minute, typically 12 to 20. ## Footnote Memory trick: FRR as 'freaking respiratory rate, man.'
63
What is FIO2?
Oxygen concentration, typically between 35% to 100%. ## Footnote Higher oxygen percentage indicates more severe patient condition. Think of FIO2 as PO2.
64
What is PEEP?
Positive end expiratory pressure, which keeps the alveoli open with positive pressure at the end of respiration. ## Footnote Key point: PEEP improves gas exchange; caution for barotrauma and pneumothorax.
65
What does PS stand for?
Pressure support, which helps with spontaneous breathing. ## Footnote Memory trick: PS is spontaneous breath support.
66
What complication is associated with excessively high levels of PEEP?
Barotrauma or pneumothorax, which can occur from too much pressure in the lungs. ## Footnote Remember: a popped lung from excessive pressure.
67
What is VE?
Minute ventilation, the amount of air delivered per minute. ## Footnote Memory trick: VE stands for ventilations every minute.
68
What does PIP stand for?
Peak inspiratory pressure, the maximum pressure during inspiration. ## Footnote Memory trick: PIP is the tip of max pressure.
69
What is plateau pressure?
Pressure applied to hold open the small airways and alveoli before expiration, indicating lung compliance. ## Footnote Memory trick: Plateau is a paused lung to hold open the air sacs longer.

Adult 3 (10 decks)

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