FCCN LEVEL 1 STUDY GUIDE
V1 - Answers- 4th intercostal space, R sternal border. Use for dysrhythmias
V2 - Answers- 4th intercostal space, L sternal border.
V4 - Answers- 5th intercostal space, left midclavicular line
V3 - Answers- Midway between V2 and V4. Use for normal rhythms with no
arrhythmias
preload - Answers- the stretch before a contraction, when the ventricle fills. how wet or
dry the pt is
low preload - Answers- pt is dry, give fluids
high preload - Answers- pt is wet, give lasix, vasodilators, dialysis
contractility - Answers- how much squeeze the heart has
low afterload - Answers- dilated arteries. caused by sepsis, shock. transfer pt to ICU for
vasoconstrictors
unstable angina - Answers- chest pain that occurs while a person is at rest and not
exerting himself. caused by plaque rupture and thrombus formation
NSTEMI - Answers- ST depression or T wave inversion, cardiac ischemia. thrombus is
intermittently occlusive, causes non full thickness infarction of myocardium
STEMI - Answers- ST elevation MI, real-time ongoing death of heart tissue due to
cardiac injury. thrombus is occlusive and causes full thickness infarction
high afterload - Answers- constricted arteries. can be caused by hypothermia,
hypovolemia, cardiogenic shock. treat the cause
afterload - Answers- the resistance the ventricle muscle has to go up against to pump
out the blood. how clamped down or dilated the pt is
low contractility - Answers- give positive inotropes
positive inotropes - Answers- digoxin, dobutamine, dopamine, milrinone
stable angina - Answers- chest pain that occurs when a person is active or under
severe stress. caused by imbalance of O2 delivery and demand
, ACS - Answers- unstable angina w/ normal troponin, NSTEMI w/ elevated troponin,
STEMI with elevated troponin
MI treatment - Answers- Notify physician, obtain 12 lead ECG within 10 minutes.
Morphine - pain relief, decreases workload of heart
Oxygen if sats <92% - improve oxygenation
Nitroglycerin - increase perfusion to heart
Aspirin - stops platelets from forming
Heparin - prevents formation of fibrin
Beta blocker - slows heart, decreases O2 demand of heart
Transfer to cath lab
how to measure ST elevation - Answers- 0.06 seconds (box and a half) after J point,
count boxes vertically up from isoelectric line
J point - Answers- Point where the QRS complex and ST segment meet
QT interval - Answers- ventricular depolarization and repolarization, beginning of QRS
to end of T wave
QTc - Answers- QT corrected for heart rate, prolonged >500
sodium - Answers- 135-145
hyponatremia - Answers- causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
hypernatremia - Answers- causes: water deficit or excessive sodium intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
potassium - Answers- 3.5-5.0
hypokalemia - Answers- causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
hyperkalemia - Answers- causes: medications, renal failure, high intake, acidosis
s/s: tall peaked T waves, muscle weakness, AV blocks
calcium - Answers- 8.5-10.5
hypocalcemia - Answers- causes: excessive loss from diarrhea, malabsorption
syndromes
V1 - Answers- 4th intercostal space, R sternal border. Use for dysrhythmias
V2 - Answers- 4th intercostal space, L sternal border.
V4 - Answers- 5th intercostal space, left midclavicular line
V3 - Answers- Midway between V2 and V4. Use for normal rhythms with no
arrhythmias
preload - Answers- the stretch before a contraction, when the ventricle fills. how wet or
dry the pt is
low preload - Answers- pt is dry, give fluids
high preload - Answers- pt is wet, give lasix, vasodilators, dialysis
contractility - Answers- how much squeeze the heart has
low afterload - Answers- dilated arteries. caused by sepsis, shock. transfer pt to ICU for
vasoconstrictors
unstable angina - Answers- chest pain that occurs while a person is at rest and not
exerting himself. caused by plaque rupture and thrombus formation
NSTEMI - Answers- ST depression or T wave inversion, cardiac ischemia. thrombus is
intermittently occlusive, causes non full thickness infarction of myocardium
STEMI - Answers- ST elevation MI, real-time ongoing death of heart tissue due to
cardiac injury. thrombus is occlusive and causes full thickness infarction
high afterload - Answers- constricted arteries. can be caused by hypothermia,
hypovolemia, cardiogenic shock. treat the cause
afterload - Answers- the resistance the ventricle muscle has to go up against to pump
out the blood. how clamped down or dilated the pt is
low contractility - Answers- give positive inotropes
positive inotropes - Answers- digoxin, dobutamine, dopamine, milrinone
stable angina - Answers- chest pain that occurs when a person is active or under
severe stress. caused by imbalance of O2 delivery and demand
, ACS - Answers- unstable angina w/ normal troponin, NSTEMI w/ elevated troponin,
STEMI with elevated troponin
MI treatment - Answers- Notify physician, obtain 12 lead ECG within 10 minutes.
Morphine - pain relief, decreases workload of heart
Oxygen if sats <92% - improve oxygenation
Nitroglycerin - increase perfusion to heart
Aspirin - stops platelets from forming
Heparin - prevents formation of fibrin
Beta blocker - slows heart, decreases O2 demand of heart
Transfer to cath lab
how to measure ST elevation - Answers- 0.06 seconds (box and a half) after J point,
count boxes vertically up from isoelectric line
J point - Answers- Point where the QRS complex and ST segment meet
QT interval - Answers- ventricular depolarization and repolarization, beginning of QRS
to end of T wave
QTc - Answers- QT corrected for heart rate, prolonged >500
sodium - Answers- 135-145
hyponatremia - Answers- causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
hypernatremia - Answers- causes: water deficit or excessive sodium intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
potassium - Answers- 3.5-5.0
hypokalemia - Answers- causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
hyperkalemia - Answers- causes: medications, renal failure, high intake, acidosis
s/s: tall peaked T waves, muscle weakness, AV blocks
calcium - Answers- 8.5-10.5
hypocalcemia - Answers- causes: excessive loss from diarrhea, malabsorption
syndromes
