Exam Prep

Question 1

Treatment of AF

Answer 1

Change the rate of prolonged AF by cardioversion on the R wave and warfarin
Amiodrone (short term)
Digoxin (long term) - controls heart rate

Question 2

How do you care for an AF pt?

Answer 2

Cardiac monitoring

Question 3

What is the biological process of narrow complex tachycardia?

Answer 3

The ventricles depolarise regular with the contraction stimulated above the Bundle of His

Question 4

What can narrow complex tachycardia lead to?

Answer 4

Broad complex tachycardia and ventricular tachycardia

Question 5

What is the size of the PR interval in broad complex tachycardia?

Answer 5

Less than or equal of 3-5 small squares

Question 6

What are the 3 main causes of broad complex tachycardia?

Answer 6

1- ectopin in the ventricle - the broadest form, no conduction
2- bundle branch block - 1/2 the ventricles depolarise, narrowest form
3- ventricle pacemaker in conduction fibres

Question 7

What is the care for a pt with broad complex tachycardia?

Answer 7

See if the pt has an output, if they have an output then treat with cardioversion
If there is no output then the pt has arrested
Treat the pt not the rhythm

Question 8

What is the medical treatment for broad complex tachycardia?

Answer 8

Slow infusion of amiodarone as it is a potassium channel blocker - toxic with long term use as it can cause pulmonary fibrosis, leading to a transplant 1-2yrs after use

Question 9

How do you measure ventricular depolarisation?

Answer 9

Measure from the beginning of the down stroke until the J point

Question 10

How big is broad ventricular depolarisation?

Answer 10

> 3 small squares

Question 11

How is atrial depolarisation shown on rhythm strips?

Answer 11

Upside P waves = AV nodal
Present P waves = sinus and upright
Nodal/upside down P waves = not sinus
No P waves

Question 12

How do you measure the PR interval?

Answer 12

From the beginning of the P wave to the beginning of the QRS complex
Normal = 3-5 small squares
Flutter = no PR interval

Question 13

How can you tell if a rhythm strip is a bigemeni pattern?

Answer 13

There is an extra beat every other beat

Due to too much calcium being left over

Question 14

How do you recognise VF?

Answer 14

Different shape complex due to different pacemakers

Question 15

How can you recognise broad complex tachycardia on a rhythm strip?

Answer 15

> 100 bpm
Broad ventricular depolarisation
Rhythm irregular

Question 16

How do you recognise bundle branch block in a rhythm strip?

Answer 16

PR ratio = >1:1 (eg 2:1, 3:1 etc)

Broad complex

Question 17

What are the consequences of AF?

Answer 17

Clotting which can eventually lead to a stroke or PE
Absence of atrial kick which leads to ventricular filling time shortening
No atrial kick will lead to a decreased BP
Remodelling of the myocardium due to continuous prolonged AF - leads to ion channels changing, resulting in the rhythm not being able to changes

Question 18

What do inverted T waves mean?

Answer 18

Possible ischaemia