Exam 2

Question 1

Who is at risk for HF?

Answer 1

HTN & CAD

Males, African American, obesity, DM, stress, hyperlipidemia, ETOH, inactivity

Question 2

S & S of HTN

Answer 2

HA, fatigue, dizziness, palpitations, SOB

Question 3

CAD Risks

Answer 3

Smoker, HTN, inactivity, DM, stress, hyperlipidemia, native American, African American, family Hx

Question 4

S&S of Heart Failure

Answer 4

Tired, fatigue, SOB, palpitations, edema, weight gain

Question 5

Angina means

Answer 5

That there can be a perfusion problem to cardiac muscle

Question 6

Stable angina

Answer 6

Knows what caused it, how to fix it, predicatable, same pain every time

Question 7

Unstable angina

Answer 7

New pain, at rest or activity, came on with less effort than normal.

longer duration usually more than 10-15 min

Pain persists after Nitro

Awakens from sleep

Question 8

Unstable angina symptoms

Answer 8

SOB, nausea, dizziness, palpitations, radiation from jaw to arm.

Question 9

NSTEMI

Answer 9

non-ST elevated MI
Partial occlusion of vessel

Question 10

STEMI

Answer 10

ST elevated MI
Total occlusion of vessel

Question 11

Collateral circulation

Answer 11

When blockages occur over time, vascularature binds collaterally to avoid blockage.

Question 12

How is a diagnosis for Acute Corinary Syndrome (ACS) made?

Answer 12

S&s
Risk factors
EKG

Troponin
(T)less than0.1
(I)less than 0.03
3 sets, 3-6hrs apart (Degree of injury)
cardiac catheterization

FLP, CRP, BNP, chemistry, coags, CBC,

CXR, Echo, TEE, Stress Test

Question 13

SA node aka

Answer 13

anatomical pacemaker

Question 14

The time it takes for the impulse to go through the atrium causing depolarization (contracting)

Answer 14

🫛P wave

0.06-0.12 seconds

Question 15

Time taken for the impulse to travel through the atria, AV node, bundle of HIS, bundle branches & pirkinje fibers until just before ventricular contraction

Answer 15

PR interval

0.12-0.20 seconds

Question 16

The time taken for ventricular depolarization (contraction, the beginning of systike

Answer 16

QRS interval

<0.12 seconds

Question 17

Ventricles return to resting state, corresponds with diastole when chambers are refilling

Answer 17

T wave

Question 18

ST deviation above by more than 1mm =

Answer 18

Injury

Question 19

ST deviation below by more than 1mm=

Answer 19

Ischemia

Question 20

ST segment =

Answer 20

Diastole

Question 21

1mm small square =

Answer 21

0.04 seconds

Question 22

5 small squares or 1 large square =

Answer 22

0.2 seconds

Question 23

Calculate HR

Answer 23

Small boxes

Rwave to Rwave /1500= HR

Question 24

Sinus Bradycardia

Answer 24

HR below 60

Nonsymptomatic- athlete, sleep? Vagal maneuver

If symptomatic may push Atropine
💊doesnt help- transcutaneous pacing
Dopamine or epi infusion
May need pacemaker

Question 25

Sinus Tachycardia

Answer 25

HR 100-150 Considerations: Stress,Pain, Anemic, hypovolemic, epi, coffee? Stable- vagal maneuver Beta blocker, calcium channel blocker Unstable- synchronized cardioversion

Question 26

MI Atypical manifestations

Answer 26

Weakness, nausea, indigestion, SOB Women- back pain Diabetics- silent d/t neuropathy Geriatric- SOB, pulmonary edema, dizziness, dysrhythmia, altered mental status Ashen, clammy, cool to touch

Question 27

MI clinical manifestations

Answer 27

BP & HR ⬆️then ⬇️ Crackles JVD Hepatic enlargement Peripheral edema Distant 🩵 sounds N/V Fever

Question 28

Ventricular Tachycardia

Answer 28

EKG- tombstone, wide QRS, 100-120p Cause: Electrolyte imbalance, MI, stimulants S&S: can be awake, chest pain, palpitations, syncope Pulse: Amidodarone💊, synchronized cardioversion Pulseless: CPR, D-Fib🚨, epi, amiodarone, vasopressin 💊 VT can lead to V-Fib 💀🚨

Question 29

Ventricular Fibrillation

Answer 29

EKG: rapid, unorganized, no pulse Cardiac injury, loss of consciousness Treatment: CPR, D-Fib, possible intubation Drugs: Epi, Amiodarone, Bicarb

Question 30

Synchronized Shock is given to

Answer 30

A-Fib Stable- has a QRS complex Shock delivered during R wave 🌊

Question 31

Defibrillation is given to

Answer 31

V-Fib or pulseless V-Tach Need AED🔋 CPR

Question 32

Atrial Fibrillation

Answer 32

EKG: irregular, unknown p wave (atrial problem) Causes- HF, COPD, HTN S&S: Tachy, palpitations, dizzy, fatigue (Due to ⬇️oxygen) Stable: 💊Beta Blockers, CCB, Amiodarone, Eliquis🩸 Unstable: Synchronized Cadioversion

Question 33

Premature Ventricular Contractions

Answer 33

EKG: inverted QRS Cause: HF, Stress, 💊, ☕️, 🍷, pain Treatment: ⬇️stress, ☕️, 💊 S&S: skipped heartbeat

Question 34

ASystole

Answer 34

EKG: flat Causes: MI, HF, cardiac Tamponade Treatment: CPR Do NOT shock 🛑

Question 35

Atrial Flutter

Answer 35

EKG: Sawtooth, can’t tell P wave 🌊 Cause: CAD, HTN, PE, S&S: fatigue, low BP, palpitations Stable: CCB, Amiodarone, Eliquis 💊 Unstable: synchronized cardioversion 🛑do NOT shock!

Question 36

Supraventricular Tachycardia

Answer 36

EKG: no P wave, Tachy (151+) Cause: Wolff Parkinson White, stress, electrolyte S&S: ⬇️BP, SOB, chest discomfort Stable: valsalva🚽, Adenosine💀, Beta blocker, Cardiac Ablation, Digoxin Unstable: Synchronized cardioversion

Question 37

MI EKG

Answer 37

ST elevation - no oxygen (STEMI) ST depression- low oxygen