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Nur 4512 Tech > Medical Emergencies Lab > Flashcards

Medical Emergencies Lab Flashcards

1
Q

• Device used for patients with bradydysrhythmias & heart blocks.

A

Cardiac Pacemakers

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2
Q

Used for emergency pacing; large pacing pads placed on chest;
generator set to deliver impulses at set rate, voltage.

A

External (temporary)

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3
Q

Inserted during cardiac surgery (temporary); lead wires on epicardial surface )

A

epicardial (temporary)

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4
Q

Lead wires threaded into atrium & ventricle(s) via subclavian vein & battery implanted in sub-q pocket surgically

A

Implanted (permanent)

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5
Q

Pacer is “seeing” the pt’s own rhythm & not pacing over it. (Failure: pacer spikes falling in random places & close to pt complexes)

A

Sensing

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6
Q

Pacer spikes followed by complexes @ regular intervals. (Failure: Long pauses w/ no pacer spikes)

A

Pacing

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7
Q

Pacer spike causes vent. to contract as evidenced by QRS complex immediately after the spike. (Failure: Presence of pacer spikes that are not followed by QRS complexes).

A

Capture

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8
Q

• Purpose: Prevention of sudden cardiac death.

  • Can deliver high-energy electrical impulses to restore heart’s rhythm (shocks are painful).
  • Used for patient’s having recurrent V-fibrillation, V-tachycardia episodes
  • Implanted like pacemaker
  • Can be programmed to serve as pacemakers
A

ICD or AICD

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9
Q

• Post-implantation Care:

A
  • bedrest ~ 6 hrs
  • telemetry monitoring
  • VS q 1-4 hrs
  • prophylactic antibiotic prn
  • assess incision.
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10
Q

Teaching ICD or IACD

A

1) Don’t put stress on incision site/leads (immobilize arm for 24 hr in sling).
2) Don’t raise arm over head or lift anything for 4-6 months
3) See MD for CP, SOB, swelling sudden weight gain
4) Assess wound for infection
5) Keep ID card & Medic-alert jewelry with you.
6) No contact sports
7) Prevent interference w/ device: avoid cell phones on side of device; welding equip.; high-current industrial equip.; TENS units; lithotripsy;
MRIs;
(airport scanners; dept store scanning devices; microwaves & other household appliances are OK)

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11
Q

Description:
• Temporary (days), implanted device used to augment failing ventricular function.
• Inserted via femoral artery & threaded into position in the descending aorta.
• Balloon set to inflate during diastole (augments CA filling; pushes blood into CA) & deflate during systole (reduces afterload; creates a vacuum).

A

IABP

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12
Q

Uses for AIBP

A
  • Post-cardiac surgery
  • Refractory CHF
  • Cardiogenic shock (i.e. MI)
  • Refractory unstable angina
  • Septic shock
  • Non-cardiac surgery w/ altered CO
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13
Q

 Placement of a catheter into the vascular system to monitor progress and therapy of critically patients.

A

cardiac cath - hemodynamic monitoring

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14
Q

Progression of Catheter in hemodynamic monitoring throgh the heart

A
  • peripheral artery or central vein
  • Rt Atrium
  • Rt Ventricle
  • Pulmonary artery
  • sutured in place
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15
Q

Normal Arterial B/P (lt heart afterload/SVR)

A

MAP at least 65mmHg

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16
Q

Normal Right Atrial/CVP (rt heart preload)

A

0-8mmHg

17
Q

Normal Pulmonary artery pressure/PAP (rt. heart afterload/PVR)

A

Normal = 15 mmHg mean (15-25 systolic. & 6-12 diastolic)

18
Q

Normal PAWP (PAOP/PWP) (lt. heart preload)

A

Normal = 4-12 mmHg

19
Q

Normal Cardiac ouput

A

4-8 L/min

20
Q

Indications for Hemodynamic Monitoring

A

 MI
 CHF
 shock states
 trauma
 cardiac surgery
 non-cardiac surgery in high risk pts.

21
Q

for injection of air (~ 1.5 ml) to inflate balloon at distal tip of catheter for obtaining PAWP

A

balloon inflation port

22
Q

has a temperature-sensitive wire near proximal end of catheter for CO readings after saline injection

A

CO thermister port

23
Q

CPR compressions:breaths ratio

A

30:2, 15:2 (before puberty)

24
Q

how fast do you perform compressions in CPR

A

100bpm (stayin alive)

25
Q

decreases oxygen consumption, infarct size, mortality and arrhythmic deaths, by improving the heart’s ability to relax and decrease the heart rate. When used long term, improve heart’s pumping ability

A

Beta Blockers

  • -lol
26
Q

Used in pts with refractory angina or A.Fib, hypertension, or angina. Decreases blood pressure, contractlity and peripheral vascular resistance (PVR). dilates coronary arteries.

A

Calcium Channel Blockers

  • Norvasc (amlodipine)
  • Cardizem (diltiazem)
  • Cardene (nicardipine)
27
Q

MONA

A
  • Morphine
  • Oxygen
  • Nitrate
  • Aspirin
28
Q

increases coronary artery flow via dilation. Decreases preload

A

Nitrates: Nitroglycerine, Imdur

29
Q

For pain and vasodilation

A

morphine

30
Q

assists in supply and demand

A

oxygen

Nur 4512 Tech (7 decks)

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