NREMT: Cardiology & Resuscitation Flashcards
There are two types of valves in the heart. The mitral and tricuspid valves are which kind of valve?
- Atrioventricular
- Aortic
- Pulmonic
- Semilunar
Atrioventricular
The two types of valves in the heart are atrioventricular and semilunar. The mitral (bicuspid) valve and the tricuspid valve are atrioventricular valves, meaning the separate the atria and ventricles. The pulmonic and aortic valves are both semilunar valves.
You are called to a minor traffic accident. One driver reports no injuries. The other driver’s car was hit on its side, and the occupant reports a “tearing” or “ripping” sensation in their lower back. The patient has a pulse of 112, BP 82/52, respirations 26, and has no neck tenderness on palpation. The most immediate concern is that this patient could have?
- An abdominal aortic aneurysm (AAA)
- A spinal injury that will require c-spine stabilization and a backboard
- Severe external bleeding that has not yet been discovered
- A spinal injury that will require only a neck collar and bandaging for any lacerations
An abdominal aortic aneurysm (AAA)
All symptoms are common of an AAA. The patient is showing signs of shock and denies any neck pain, making c-spine a lower priority than O2 therapy and immediate transport.
During CPR, compressions should be performed at which of the following rates?
- 60-80 per minute
- 100-120 per minute
- 80-100 per minute
- 125-150 per minute
100-120 per minute
The AHA has reviewed numerous studies and found that a rate between 100 - 120 is best when performing chest compressions to help maintain blood flow to the vital organs.
Which of the following terms describes inadequate blood supply to the heart secondary to an acute myocardial infarction?
- Cyanosis
- Angina
- Hypoxic
- Ischemia
Ischemia
Ischemia is a medical term that refers to inadequate blood supply to a part of the body.
You respond to the scene of a motor vehicle accident. Your patient is a 46-year-old male who is complaining of chest pain. The patient states his chest hit the steering wheel during the accident. He is pale, diaphoretic, and you note distended neck veins. His pulse is 120, BP 88/59, RR 20. Upon examination you notice bruising to his chest, but no broken ribs. Lung sounds are clear on both sides, but heart tones are muffled. What do you suspect is going on with this patient?
- Cardiac tamponade
- Pulmonary embolism
- Tension pneumothorax
- Hemothorax
Cardiac tamponade
Trauma to the chest is a common cause of cardiac tamponade. This patient is exhibiting the classic signs of hypotension, JVD and muffled heart tones.
How often should rescuers switch roles during CPR?
- Every two minutes or five cycles of CPR
- After every round of CPR
- Whenever the rescuers begin to feel fatigued
- Every five minutes
Every two minutes or every five cycles of CPR
It is important rescuers switch between compressions and breaths every two minutes to ensure high-quality CPR. If you become tired during CPR, chances are high that your compressions will become inadequate, reducing the victim’s chance of survival.
You are dispatched to a 28-year of male who is complaining of stabbing chest pain the center of his chest. On your arrival the patient states that he has had this chest pain for 3 days. His only complaint prior to the chest pain was a runny nose. Currently his vitals are BP 150/70, HR 120, respirations 22, SPO2 is 91%, temperature 99.6, and glucose 120. Which is of the following is the most appropriate treatment for this patient?
- Administer Nitroglycerin 0.4 mg SL
- Place patient on O2 at 4L by nasal cannula
- Administer Tylenol 1000 mg PO
- Administer Aspirin 324 mg PO
Place patient on O2 at 4L by nasal cannula
This patient is mildly hypoxic. Any patient who is showing signs of hypoxia should have O2 administered first.
The right ventricle is responsible for which of the following actions?
- Pumping blood to the body
- Receiving blood from the lungs
- Receiving blood from the veins of the body
- Pumping blood to the lungs
Pumping blood to the lungs
The right ventricle is responsible for pumping deoxygenated blood to the lungs. Remember that diagram of the blood flowing through the body with red or blue signifying oxygenated or deoxygenated blood? This question is easy once you have that down!
You have been dispatched to a 68-year-old patient with chest pain and you arrive on scene to find him supine on the floor. Unknown down time and your initial assessment reveals that he is pulseless and apneic. What statement is most accurate about how you should initially treat this patient?
- Start CPR and prepare for immediate transport
- 5 cycles of CPR before attaching AED as soon as possible
- Start CPR and attach an AED as soon as possible
- Ask the family if he has a DNR
Start CPR and attach an AED as soon as possible
Regardless of whether the arrest is witnessed or not, the healthcare provider should begin CPR and then attach an AED as soon as one becomes available.
Which blood vessel is responsible for delivering oxygen-poor blood to the heart?
- The aorta
- The vena cava
- The jugular vein
- The left ventricle
The vena cava
The vena cava delivers oxygen-poor blood to the left atria for circulation to the lungs
All of the following would be considered things to avoid when doing CPR, except for?
- Minimize pauses in compressions
- Compress the chest at a rate of 150/min
- Lean on the chest between compressions
- Compress the chest at a depth of 1 - 1.5 inches
Minimize pauses in compressions
Which one of these victims is most likely to need CPR?
- A victim who seems to be making a snoring or gasping sound who is also unresponsive
- A 56-year-old male experiencing chest pain
- A 40-year-old male victim who is breathing, but unconscious with a possible head injury
- A teenage female who just fell off a 20’ foot ladder
A victim who seems to be making a snoring or gasping sound who is also unresponsive
Agonal respirations are categorized by a snoring or gasping sound, also known as death breaths. If this type of breathing is noted, then the victim should be treated as if they are not breathing.
How do you calculate cardiac output?
- Blood pressure x Heart rate
- Heart rate x Respiratory rate
- Stroke volume x Heart rate
- Stroke volume x Lung capacity
Stroke volume x Heart rate
Cardiac output is the amount of blood your heart pumps out in one minute. Stroke volume is the amount of blood pumped out to the body with every beat. To calculate cardiac output, you need to multiply the amount of blood pumped out during every beat by the heart rate.
Which of the following is a set of vitals that is indicative of cardiac tamponade in a patient?
- Beck’s Triad
- Pulsus Paradoxus
- Cushing’s Triad
- Cor Pulmonale
Beck’s Triad
Beck’s triad are a set of vitals that often indicate cardiac tamponade. The following vitals are a part of Beck’s triad: hypotension, jugular venous distention, and muffled heart sounds.
When performing adult CPR, how far should you compress the chest?
- At least two inches, not more than 2.4 inches
- 1.5 inches - 2 inches
- At least one inch
- 1/3 the depth of the torso
At least two inches, not more than 2.4 inches
The depth on an adult is at least 2” (not more than 2.4”) and the compression rate is 100 - 120/min. The key to good compressions is to ensure that you have proper recoil, allowing the chest to come back up completely before giving another compression.
Arteries carry blood _____ the heart and veins bring blood _____ the heart
- Away from, Through
- Away from, Back to
- Back to, Away from
- Through, Away from
Away from, Back to
The Great Vessels are a combination of arteries and veins that allow blood flow between the heart, lungs, and the rest of the body. Arteries carry blood away from the heart and veins bring blood to the heart.
Which of the following is correct in ranking the importance of CPR components during a pediatric arrest?
- Chest compressions, breathing, airway
- Airway, breathing, chest compressions
- Chest compressions, airway, breathing
- Airway, chest compressions. breathing
Chest compressions, airway, breathing
Chest compressions are the most important part of CPR as they circulate blood through the body and perfuse vital organs. Interruptions to chest compressions should be minimal (pulse check, shock delivery) and chest compressions should be resumed as soon as possible.
Your patient is a 64-year-old female reporting 8/10 chest pain. Which finding most raises your index of suspicion for a cardiac history?
- A four-inch scar directly above the sternum
- Taking one 81 mg tablet of acetaminophen per day
- Blood pressure of 114/78
- HR of 82
A four-inch scar directly above the sternum
A scar above the heart can be a sign that the patient has had a major cardiac surgery in the past. Both the BP and HR are within normal limits, and although taking a daily aspirin can be a sign of a cardiac history, it alone is not indicative of major heart problems.
How many valves does the heart have?
- 4
- 3
- 2
- 5
4
The heart has four valves. Tricuspid, Bicuspid (mitral), Aortic, Pulmonary.
Which of the following BEST describes Pericarditis?
- Inflammation affecting all of the lung tissue
- Inflammation affecting the innermost layer of the heart
- Inflammation affecting the outermost layer of the heart
- Inflammation affecting the muscle tissue of the heart
Inflammation affecting the outermost layer of the heart4
Pericarditis is the inflammation affecting the pericardium, which is the lining surrounding the heart, responsible for enclosing it and protecting it from surrounding structures.
Which one of these statements about compression depth is true?
- You should push hard and fast, erring on the side of going too deep rather than too shallow
- Making sure not to compress the chest too deep ensures that the victim will not have permanent chest wall damage
- Compression depth is not nearly as important as giving proper breaths
- You should compress the chest wall just enough to see a slight impression on the victim’s chest
You should push hard and fast, erring on the side of going too deep rather than too shallow
When CPR is being performed, the goal is to pump blood to the vital organs; this can be directly hindered by not compressing the chest deep enough. Proper CPR is crucial to a victim’s chance of survival.
Brain damage begins roughly how long after the patient suffers cardiac arrest?
- 8-10 minutes
- 1-2 minutes
- 4-6 minutes
- 12-15 minutes
4-6 minutes
Brain damage begins roughly 4-6 minutes after patients experience cardiac arrest. Circulating blood and getting oxygen to the brain is why good chest compressions are so vital during cardiac arrest.
You are driving your ambulance to the ER while your partner is treating a middle-aged man in the back of the ambulance for an AMI. He has been stabilized, is on high-flow oxygen, and is conscious. After a brief commotion, your partner informs you that the patient has lost consciousness and his EKG reading is indicating cardiac arrest. You are 10 minutes out from the hospital. What should you do?
- Request additional resources, pull over and help your partner with CPR
- Request additional resources to meet at a specified location
- Have your partner apply 15 Lpm of high-flow oxygen
- Increase your speed slightly and go emergent
Request additional resources, pull over and help your partner with CPR
Cardiac arrest is a life threat that needs to be dealt with immediately and because the time from ER is so significant, the patient’s best chance of survival depends on immediate compressions.
Which of the following is a contraindication for Nitroglycerin administration?
- Tachycardia
- Bradycardia
- Hypertension
- Hypotension
Hypotension
Due to the vasodilator effects of nitroglycerin, it is important to assess the patient’s blood pressure prior to administration. Patients who are experiencing hypotension should not take nitroglycerin because it may worsen their hypotension.
Your ALS partner suspects the patient you are treating is experiencing cardiogenic shock. Which of the following presentations would your patient most likely not have?
- Pulmonary edema with wheezes or rales
- Slow heart rate
- Hives
- Chest pain
Hives
The left atrium is responsible for which of the following actions?
- Pumping blood to the lungs
- Receiving blood from the lungs
- Pumping blood to the body
- Receiving blood from the veins of the body
Receiving blood from the lungs
The left atrium is responsible for receiving blood from the lungs. This blood is oxygenated.
If your patient is experiencing 10/10 chest pain but states that they get hives when they take Aspirin, you should?
- Administer a half-dose of Aspirin
- Withhold Aspirin
- Administer Aspirin
- Administer only one tablet of Aspirin (81mg)
Withhold Aspirin
A contraindication of Aspirin administration is an allergic reaction or sensitivity to the drug.
While performing chest compressions, what should you allow time for after each compression?
- Recoil
- Rhythm check
- Delivery of ventilations
- Pulse check
Recoil
You want to ensure that every time you deliver a chest compression you are allowing for proper recoil of the chest wall.
The sinoatrial node is also called the?
- The left ventricle
- The pacemaker of the heart
- The electrical conduction system of the heart
- The bundle branch of the heart
The pacemaker of the heart
The sinoatrial node generates nerve impulses that allow the heart to fire or contract.
After you have checked your patient for responsiveness during the BLS survey, what is your next course of action?
- Deliver two rescue breaths
- Attach the AED
- Start compressions
- Activate the emergency response system and get an AED
Activate the emergency response system and get an AED
If you are able , you should get an AED after activating the emergency response system. If someone is available, you can send them to do this for you.
