Perfusion

Question 1

S/S of inadequate central perfusion (4)

Answer 1

• Dyspnea
• Dizziness
• Syncope
• Chest pain

Question 2

S/S of decreased CO (6)

Answer 2

• Hypotension
• Tachycardia
• Diaphoresis
• Anxiety
• Decreased cognition
• Dysrhythmias

Question 3

S/S of decreased peripheral perfusion (4)

Answer 3

• Decreased hair distribution
• Non-localized/diffuse pain
• Coolness/pallor
• Cyanosis of extremities

Question 4

Acute Coronary Syndrome (ACS)

Answer 4

Patients either have unstable angina or an acute MI

Question 5

Angina

Answer 5

Chest pain caused by temporary imbalance of coronary arteries ability to supply oxygen and cardiac muscle’s demand for oxygen

Question 6

Unstable angina

Answer 6

Chest pain/discomfort at rest/exertion that lasts longer than 15 minutes and is poorly controlled with nitro

Question 7

Coronary Artery Disease (CAD)

Answer 7

Narrowing of the coronary arteries caused by build-up of fatty material in the walls of the arteries

Question 8

How is CAD treated?

Answer 8

Coronary Artery Bypass Graft (CABG)

Question 9

CABG Procedure

Answer 9

Large incision is made in chest by cutting sternum in half lengthwise and spreading it apart –> heart is stopped and tubes inserted into heart so blood can be pumped while heart isn’t beating

Question 10

P wave

Answer 10

• First deflection
• Upright = positive
• Indicates atrial depolarization

Question 11

PR interval

Answer 11

Depolarization and contraction of atria

Question 12

QRS complex

Answer 12

• Follows P wave
• Downward deflection –> upward deflection –> downward deflection
• Ventricular depolarization (systole)

Question 13

ST segment

Answer 13

• Occurs after ventricular depolarization has ended and before rMepolarization (diastole)

Question 14

T wave

Answer 14

• Modest upward waveform
• Represent ventricular repolarization

Question 15

MONA

Answer 15

Morphine
Oxygen
Nitro
Aspirin

Question 16

Shockable rhythms

Answer 16

• V-tach
• V-fib

Question 17

Nonshockable rhythms

Answer 17

• Asystole
• PEA

Question 18

Ventricular tachycardia

Answer 18

• Rhythm: regular/irregular
• Heart rate: 150-250/minute
• P wave: seldom seen
• PR interval: not measurable
• QRS interval: wide, distorted
  Symptoms: palpitations, lightheaded, syncope

Question 19

Ventricular fibrillation

Answer 19

• Rhythm: irregular/chaotic
• HR: not measurable
• P wave: not visible
• PR interval: not measurable
• QRS interval: not measurable
• Fatal if not treated in 3-5 minutes
• S/S: pulseless, no breathing

Question 20

1st Degree AV Block

Answer 20

• Conduction delayed through AV node
• PR interval >0.2 seconds

Question 21

Risk factors for 1st degree AV block

Answer 21

• Older age
• MI
• CAD
• Rheumatic fever
• Hyperthyroidism
• Electrolyte imbalances
• Beta blockers
• Calcium channel blockers

Question 22

2nd degree AV block type 1

Answer 22

• PR interval

Question 23

Risk factors for type 1 2nd degree AV block

Answer 23

• Digoxin
• Beta blockers
• CAD
• Inferior MI

Question 24

Treatment for type 1 2nd degree AV blocks

Answer 24

• Symptomatic = temp. pacemaker
• Unsymptoamtic = observation

Question 25

2nd degree AV block type 2

Answer 25

More p waves than QRS complexes

Question 26

Treatment for type 2 2nd degree AV blocks

Answer 26

Permanent pacemaker

Question 27

3rd degree AV block

Answer 27

• Atrial and ventricular, but beating independently
• Complete blockage

Question 28

Risk factors for 3rd degree AV blocks

Answer 28

• Conduction system disease
• CAD
• MI/ischemia
• Endocarditis
• Rheumatic fever
• Congenital heart disease
• Medications
• Toxins

Question 29

Treatment for 3rd degree AV block

Answer 29

• Permanent pacemaker
• Drugs to increase heart rate and blood pressure