NU 454 FINAL EXAM Flashcards
1
Q
Small square on ECG
A
0.04 seconds
2
Q
Large square on ECG
A
0.2 seconds
3
Q
Normal QRS complex
A
0.04-0.12 seconds
4
Q
Normal QT interval
A
< 0.4 seconds (10 boxes)
5
Q
300, 150, 100, 75, 60, 50
A
300 method to count HR
6
Q
Normal PR interval
A
0.12-0.2 seconds (3-4 boxes)
7
Q
SA node pace
A
60-100 bpm
8
Q
AV node pace
A
40-60 bpm
9
Q
Purkinje fibers pace
A
20-40 bpm
10
Q
Physiologic Q wave
A
normal variance; no problem
11
Q
Pathologic Q wave
A
shows previous infarction
12
Q
II, III, aVF
A
Inferior view of the heart
13
Q
I, aVL, V5, V6
A
Lateral view of the heart
14
Q
V1, V2
A
Septal view of the heart
15
Q
V3, V4
A
Anterior view of the heart
16
Q
Sinus Bradycardia Tx if symptomatic
A
- Maintain airway/oxygenate
- S/S: changed mental status, chest pain, cool, clammy, hypotension
- Prepare for transcutaneous pacing
- Atropine 0.5 mg q 3-5 min (max 3 mg)
- Dopamine 2-10 ug/kg/min
- Epinephrine 2-10 ug/min
17
Q
“Pre-excitation”; type of SVT
A
Wolf Parkinson White Syndrome
18
Q
SVT tx
A
- Vagal maneuvers
- Adenosine
- BBs, CCBs
- Cardioversion
19
Q
Atrial flutter and fibrillation tx
A
- BBs, CCBs,
- Amiodarone, antidysrthymics
20
Q
Junctional Rhythm rate
A
40-60 bpm
-normal QRS
21
Q
Ventricular Escape Beat/Idioventricular Rhythm rate
A
20-40 bpm
-wide QRS
22
Q
First degree AV block
A
prolonged PR interval (>.2 seconds)
23
Q
Second degree AV block Type I
A
Prolonged PR interval and then DROPPED
24
Q
Second degree AV block Type II
A
Ratio of P to QRS
-Needs permanent pacemaker!
25
Third degree AV block
No consistency between P and QRS
26
Common electrolyte imbalance in Torsades
Magnesium
27
The pacemaker does not recognize normal beats and fires inappropriately
Failure to sense
28
The chamber has not responded to a pacing stimulus
Failure to capture
29
PEA/Asystole tx
- no pulse
- unshockable rhythm
- CPR
- Epinephrine 1mg q 3-5 min
- Consider Vasopressin for first or second dose of epinephrine 40U
30
If hypotension is < 60
Give epinephrine for bradydysrthymias
31
6 H's
1. Hypovolemia
2. Hypoxia
3. Hydrogen ions (acidosis)
4. Hyperkalemia/Hypokalemia
5. Hypothermia
6. Hypoglycemia
Differential diagnoses
32
5 T's
1. Tablets (overdose)
2. Tamponade
3. Tension Pneumothorax
4. Thrombosis (heart)
5. Thrombosis (lungs)
Differential diagnoses
33
If known hyperkalemia or overdose of TCAs
Give sodium bicarbonate
34
Pulseless VF/VT tx
- Oxygen
- Shockable rhythm
- Defibrillate
- CPR
- Epinephrine 1 mg q 3-5 minutes
- Vasopressin 40 U can be replaced for first or second dose; given ONCE
- Amiodarone 300 mg; second dose 150 mg
- Mag if Torsades
35
Hyperkalemia
Bradydysrhythmias
36
Hypokalemia
Tachydysrhymias
37
Monophasic defibrillation
360 Joules
38
Biphasic defibrillation
120-200 Joules
39
Stable narrow/regular tachycardia tx
- no s/s
- vagal maneuvers (cough)
- adenosine 6 mg in 1-3 seconds; repeat dose 12 mg in 1-2 minutes if needed
- repeat 12 mg of adenosine only once
- Diltiazem, beta blockers
40
Unstable tachycardia
CARDIOVERT
41
Stable narrow/irregular tachycardia tx
- probably afib or aflutter
| - Diltiazem, beta blockers
42
Stable wide/regular tachycardia tx (>.12 seconds)
-adenosine if regular and monomorphic
43
Stable wide/irregular tachycardia
Antidysrthymics
44
Procainamide
- stable wide/irregular tachy
- 20-50 mg/min
- 17 mg/kg MAX
- Maintenance 1-4 mg/min
45
Amiodarone
- stable wide/irregular tachy
- 150 mg over 10 minutes
- Maintenance 1 mg for 6 hours
46
Sotalol
- stable wide/irregular tachy
| - 100 mg over 5 min (1/5 mg/kg)
47
Synchronized Cardioversion
- Narrow Regular
- Narrow Irregular
- Wide Regular
- 50-100
- 120-200
- 100
48
Required MAP for adequate perfusion of brain
50-500
49
Normal CPP
60-100
50
Cushing's Triad
HTN, bradycardia, widened pulse pressure, irregular respirations
51
Result of interruption of voluntary motor tracts in the cerebral cortex
Decorticate Posture
52
Results from disruption of motor fibers in the midbrain and brainstem
Decerebrate Posture
53
Normal jugular venous bulb catheter pressure
55% to 75%
54
LICOX catheter
- 20-40 mm Hg
| - measures oxygen, brain tissue temperature, and ICP
55
Calculating CPP
MAP-ICP
56
Calculating MAP
SBP + 2DSP / 3
57
Osmotic diuretic given through a filter to decrease CSF
Mannitol (Osmitrol)
58
Reduce inflammation but you have to monitor hyperglycemia
Corticosteroids for tx of ICP
59
Hypotonic Solution
5% Dextrose
0. 45% Sodium Chloride
- cause swelling
60
Neurologic emergency; initial period of unconsciousness, then lucid interval, followed by a decrease in LOC
Epidural hematoma
61
Worst HA of life, decreased LOC, nucal rigidity, brudinski's reflex
Subarachnoid hemorrhage
62
Chin tuck causes knees to lift
Brudinski's reflex
63
Brain tumors make a patient at risk for
seizures and increased ICP
64
HA, N/V, papilledema, visual symptoms, seizures, and changes in mentation
s/s brain tumor
65
Hemiplegia, seizures, memory deficit, personality changes
frontal lobe
66
Speech disturbances
parietal lobe
67
Blindness and seizures
occipital lobe
68
Seizures and dysphagia
temporal lobe
69
Cranial nerve V
Trigeminal neuralgia
70
Cranial nerve VII
Bell's palsy
| -herpes vesicles
71
Descending paralysis
botulism poisoning
72
Passive immunity for tetanus
IG
73
Active immunity for tetanus
Tetanus vaccine
74
Flexing thigh and knee causes back pain
Kernig's sign
75
Polymorphonuclear WBC's > 1,000
| Protein > 500
Bacterial Meningitis
76
If the patient attempts to breath, ventilator will ventilate each breath attempted
Assist-Control
77
Delivers preset rate and depth, but patient can breath on their own in between ventilator breaths
Synchronized intermittent mandatory ventilation
78
Acute respiratory infection caused by coronavirus
| -s/s: fever, sore throat, rhinorrhea, chills, rigors, myalgia, headache, diarrhea
severe acute respiratory syndrome (SARS)
