Quiz 1 Cardiac Practice

Question 1

what is the cardiac conduction system

Answer 1

SA node (Pacemaker of the heart), AV node, Bundle of His, Purkinje Fibers

Question 2

________ causes heart to contract

Answer 2

depolarization

Question 3

how big is one small sq on a EKG

Answer 3

0.04

Question 4

what is telemetry

Answer 4

box with leads that is most common at hospital

white on right, clouds over grass, smoke over fire

Question 5

describe a normal PR interval

Answer 5

3-5 small blocks (0.12 - 0.20)

atrial depolarization

Question 6

describe p wave

Answer 6

depolarization of atria

Question 7

describe QRS

Answer 7

depolarization of ventricles

1-3 small blocks (0.04 - 0.10)

Question 8

describe T wave

Answer 8

repolarization of ventricles

Question 9

what is Dubins method

Answer 9

300, 150, 100, 75, 60, 50, 43, 38, 33, 30

Question 10

what are the most common causes of dysrhythmias

Answer 10

hypoxia (no oxygen)

ischemia (no blood flow)

Question 11

what are additional causes of dysrthythmias

Answer 11

sympathetic stimulation
medications
electrolyte imbalance
stretch or hypertropy

Question 12

what happens if there is too much K

Answer 12

elevated T waves and eventually heart stops

Question 13

what is sinus bradycardia and treatment

Answer 13

decreased cardiac output
rate <60
*atropine and pacemaker

Question 14

what is first degree heart block and treatment

Answer 14

PR is prolonged
rate <60
*atropine

Question 15

what is Wenkebach and treatment

Answer 15

second degree heart block
PR is longer, longer, longer and then drops a beat
*atropine

Question 16

what is Mobitz type two and treatment

Answer 16

second degree heart block
beat drops every other beat
poor perfusion
*atropine

Question 17

what is third degree heart block and treatment

Answer 17

brady
AV dissociation
P wave is independent from QRS
*pacemaker

Question 18

what is atrial flutter

Answer 18

saw tooth

atrial rate is 250-350

Question 19

what is atrial fib and treatment

Answer 19

NO p waves
ALWAYS irregular
*most common dysrhythmia d/t CHF
**Calcium channel blocker or cardioversion

Question 20

what is sinus tachycardia and treatment

Answer 20

rate >100

*beta blocker, calcium channel blocker

Question 21

what is atrial tachycardia

Answer 21

p wave is irregular BUT visible

rate >150

Question 22

what is supraventricular tachycardia and treatment

Answer 22

QRS is very narrow
rate >160
cannot determine P wave (NOT visible)
*adenosine or cardioversion if drug doesnt work

Question 23

what types of PVCs are bad

Answer 23

frequently occur (multiple in 6 sec)
couplets (NO perfusion)
multiple foci (multiple areas of irritation)

Question 24

describe PACs

Answer 24

do NOT treat
irregular beat
usually d/t sympathetic stimulation

Question 25

describe v tach and treatment

Answer 25

NO p wave
rate about 150
go in and out of, no constant 
**amiodarone IF pulse
**compressions if NO pulse

Question 26

what do you do if monitor says pt is in v tach

Answer 26

** always check pt first
-if NO pulse, start compressions
-if pt talks to you, check BP and ask if having chest pain?
pt will code, give O2 and lay down

Question 27

describe polymorphic and treatment

Answer 27

v tach in multiple areas
often d/t lack of Mg
*give Mg IV

Question 28

describe V fib

Answer 28

no contraction, no cardiac output

*defibrillation

Question 29

what to do in order if pt codes

Answer 29

1) begin compression
2) epinephrine
3) defibrillation
4) repeat epi then defib

Question 30

causes of sinus tachy

Answer 30

Stress, exercise, fever, pain, meds, metabolic demands, hypovolemia- can lead to decreased diastolic filling time, < SV and cardiac enlargement

Question 31

treatment for sinus tachy

Answer 31

Beta Blockers- Metoprolol or Labetolol

Calcium Channel Blockers- Diltiazem (Cardizem)

Question 32

causes of sinus brady

Answer 32

Decreased automaticity of SA node, HB, dig toxicity, MI, Hyperkalemia

Question 33

treatment of sins brady

Answer 33

atropine and pacemaker

Avoid any suctioning, gag reflex

Question 34

cause of atrial tachy/SVT

Answer 34

May have runs without problems, fever, stress, adrenergic meds, caffeine, hypertrophy of atrium, asthma
Leads to increased workload, < coronary bloodflow and < C.O.

Question 35

treatment of atrial tachy and SVT

Answer 35

Adenosine (Adenocard)
Diltiazem (Cardizem)-
Carduiversion

Question 36

causes of atrial fib and atrial flutter

Answer 36

CHF, LV failure, injury to SA node, catecholamine secretion

Question 37

treatment of atrial fib and atrial flutter

Answer 37

Cardizem
Digoxin
Amiodarone
Cardioversion
Anticoagulants, esp for A. fib

Question 38

causes of V tach and V fib

Answer 38

Myocardial irritability, M.I., ischemia, plaque formation, toxic irritation from drugs & chemical, mechanical irritation from leads, hypoxia and hypertrophy of ventricles

Question 39

transition of pt with V tach

Answer 39

angina, apprehension, < CO, < BP, unresponsive

Question 40

treatment of v tach

Answer 40

PULSE: amiodarone

NO PULSE: compression, epi, shock

Question 41

treatment of V fib

Answer 41

compressions, epi, DEFIBRILLATION

Question 42

sodium range

Answer 42

136 - 145 mEq/L

Question 43

potassium range

Answer 43

3.5 - 5 mEq/L

Question 44

calcium range

Answer 44

9 - 10.5 mg/dL

Question 45

chloride range

Answer 45

98 - 106 mEq/L

Question 46

magnesium range

Answer 46

1.8 - 2.6 mEq/L