Week 3

Question 1

List the sites for IM injections.

Answer 1

• dorsogluteal
• deltoid
• vastus lateralis
• ventrogluteal

Question 2

Pulmonary circulation is pumped through which side of the heart?

Answer 2

It is pumped through the right side of the heart

Question 3

The systemic circulation is pumped through which side of the heart?

Answer 3

It is pumped through the left side of the heart.

Question 4

What is stroke volume?

Answer 4

Amount of blood ejected from each ventricle with each heartbeat.

Question 5

What is preload?

Answer 5

The end of diastole; it is the pressure on walls of the ventricles by volume of blood filling the ventricles at the end of diastole

Question 6

It is vital, to get the position of the ECG chest electrodes correct. Where should they be placed?

Answer 6

Limbs = L & R wrists
-L & R legs (just above the ankle)
V1= 4th intercostal space counting down the pt’s R sternal notch on the R sternal edge
V2= 4th intercostal space counting down rom the pt’s L sternal notch on the L sternal edge
V3= should be positioned midway between V2 and V4
V4= should be positioned in the 5th intercostal space, counting down the middle of the pt’s clavicle
V5= should be positioned in line with V4 but on the axillary line
V6= should be positioned in line with V4 but in the axillary line.

Question 7

To obtain a good-quality ECG tracing you need to make sure that there is no outside interference, as this can create artefact. What are the 3 most common causes of artefact?

Answer 7

1. main interference
2. pt movement
3. wandering baseline

Question 8

what does the P wave represent?

Answer 8

the spread of the impulse from the SA node across the atria (atrial depolarisation)

Question 9

What does the PR interval represent?

Answer 9

the time taken for the impulse to spread over the atrium and through the AV node, where the impulse pauses for a short time

Question 10

What does the QRS complex represent?

Answer 10

the spread of the impulse through the ventricles (ventricular depolarisation)

Question 11

What does the T wave represent?

Answer 11

represents ventricular recovery (repolarisation)

Question 12

What are we assessing for in a ECG rhythm strip analysis?

Answer 12

• rate
• rhythm= regular or irregular
• atrial activity
• ventricular activity = broad, narrow or normal
• relationship
• intervals
• name/description

Question 13

An ECG represents...
A) the structure of the heart
B) movement of electrical impulses through the heart
C) movement of blood through the heart
D) the state of the coronary arteries

Answer 13

An ECG represents...
A) the structure of the heart
B) movement of electrical impulses through the heart*
C) movement of blood through the heart
D) the state of the coronary arteries

Question 14

Electrical conduction of the heart's cells is also known as..
A) polarisation
B) repolarisation
C) depolarisation
D) defibrillation

Answer 14

Electrical conduction of the heart's cells is also known as..
A) polarisation
B) repolarisation
C) depolarisation*
D) defibrillation

Question 15

The conduction pathway is composed of?

Answer 15

starts at the:

• sinoatrial node(SA) then moves to the
• atrioventricular node (AV)
• the bundle of HIS through the
• R + L branches and then to the
• purkinje fibres

Question 16

What assessment would we performing for a cardiovascular assessment?

Answer 16

-pt hx: describe present illness and cheif complaint
-observe pt: colour, oedema, LOC,
-pain assessment
-vital signs
12 lead ECG: looking for signs of ischemia or cardiac pathology
-respiratory assessment
-urine output and sample
-assess R side of neck for venous congestion (vein distension)

Question 17

How do we perform a 6 second HR measurement calculation on an ECG?

Answer 17

• count the R waves on a 6-s strip and multiply by 10 to calculate the rate for one minute

Question 18

Define shock.

Answer 18

Shock is an altered physiological state that effects the functioning of every cell and organ system in the body.

Question 19

define oligoanuria

Answer 19

fluid retension

Question 20

define Hypovolaemic shock

Answer 20

a reduction in circulating blood volume through haemorrhage or dehydration or plasma fluid loss.

Question 21

What are the management principles of shock?

Answer 21

treatment of shock focuses on treating the underlying cause, restoration and optimisation of perfusion and oxygen delivery

Question 22

What does the mnemonic VIP stand for?

Answer 22

V- ventilation, including airway, added oxygen and ventilation
I- infusion of appropriate volume expanders
improved heart P-pumping with drug therapy such as antiarrhythmics, inotropes, diuretics and vasodilators

Question 23

What does the mnemonic FASTHUG stand for?

Answer 23

F-feeding (preventmalnutrition, promote adequate calorie intake)
A-analgesia (reduce pain, improve physical and psychological wellbeing)
S-sedation (titrate to the 3c’s=calm, cooperative, comfortable)
T-thromboembolic prophylaxis (prevent DVT)
H-head of bed elevate (up to 45* to reduce reflux and VAP)
U-ulcer prophylaxis (prevent stress ulcers)
G- glycaemic control (maintain normal BGLs)

Question 24

what is the pt management for hypovolaemic shock?

Answer 24

• focuses on fluid loss minimisation and restoring blood volume after A and B are secure
• more than 1 large bore cannulae should be inserted
• maintain pt body temp above 35 to avoid complications
• fluid resuss is a 1st line treatment
• for moderate to severe hypovolaemia, blood is used to improve O2 carrying capacity
• document= fluid type, volume and rate and target end points

Question 25

What factors affect cardiac output?

Answer 25

• preload
• afterload
• contractility

Question 26

How we assess cardiac output?

Answer 26

• need to be doing a continuous cardiac monitoring ( through ECG)
• Monitoring haemodynamic = through non-invasive(BP & Oximetry), Invasive (pulmonary artery pressure & central venous pressure)