CEN Sample Test Questions and Answers

Right ventricular infarction (RVI) lead changes II, III, AVF R ventricular infarction s/s clear breath sounds, hypotension, JVD. R ventricular dilation and dec contractility dec preload and CO Reperfusion therapy standard Within 60 min of ED arrival Common causes of PEA Hypoxia, tension pneumo, cardiac tamponade BNP as a marker of L ventricular dysfunction bc ventricles make BNP and an inc of over 100 pg/ml indicates symptomatic HF Transcutaneous pacing (TCP) A beat after every pacer spike is electrical capture. Beats are wide complex bc ventricle is paced. Palpate central pulse, pt may still be hypotensive w/ diminished or absent peripheral pulses. Preferred tx with symptomatic brady esp in pts with acute MI Wolff Parkinson-White (WPW) syndrome shortened PR interval and widened QRS complex with a delta wave. When there is an extra electrical conduction path to heart causing electrical signal to arrive too soon at ventricle (pt presents in tachy) Brugada syndrome R bundle branch block with ST segment elevation in leads V1-V3 and inc risk of sudden cardiac death (SUDS), common in young men Wellen syndrome T wave changes plus history of anginal chest pain w/o serum marker abnormalities, EKG lacks Q waves and significant ST segment elevation. Assoc with critical proximal L anterior descending (LAD) artery stenosis Hypothermia associations With bradycardia, Osborne (J) waves and prolonged QT intervals Sick sinus syndrome Sinoatrial node (SA) the primary heart pacemaker is not functioning properly resulting in bradydysrythmias and/or tachydysrhythmias with potential for hypotension and syncope Morphine and nitrates for tx pulmonary edema Results in dec preload or dec venous return dec pulmonary congestion