N4581 - Exam 2 (Complex Needs - Reid) Questions With
Complete Solutions
Blood drawn from PAC is considered ______
(de/oxygenated).
deoxygenated
think: hasn't gone to the lungs yet, end of catheter
is sitting in the pulmonary artery
,_____ is an amino acid which contributes to
atherosclerosis. This is a _______ (modifiable/non-
modifiable) risk for _______.
homocysteine
modifiable
coronary artery disease
After giving both a diuretic and a positive inotrope,
patient chamber pressures are still high and CI is
low. What is happening?
HF is now accompanied by kidney failure
∵ prolonged poor kidney perfusion, kidneys are too
weak to move fluids out, despite diuretic
At what point during HF would mechanical
interventions be needed?
What are the two options?
if pt doesn't improve after diuretic and 3 positive
inotropes → mechanical intervention
option 1: intra-aortic balloon pump
option 2: ventricular assist device
A reduction of cardiac output causes 2 pathways to
activate
1) SNS stimulation - β stimulation - heart beats
faster - ↑O2 demands - ↑workload to meet O2
demands
2) kidneys activate RAAS - vasoconstriction & Na
,retention - more fluids - ↑workload ∵ heart can't
keep up with more fluids and ↑resistance
What is the "recipe" for interpreting ECG strip?
1) are P waves upright? (if yes: sinus)
2) equal P:QRS ratio?
3) calculate PRI
4) calculate QRS
5) calculate HR
6) name your rhythm
Define the following blocks;
1st degree
2nd degree type I
2nd degree type II
3rd degree
1st: fixed, long PRI & P:QRS
2nd type 1: lengthening PRI then dropped QRS
("longer, longer, longer, drop = Wenckebach")
2nd type 2: fixed PRI, some dropped Qs ("out of
the blue, drop a Q")
3rd: wide QRS, more Ps than Qs (each have
separate, yet fixed schedule)
, What rhythms should you "identify and treat the
cause"? (2)
What are the 5 H's and 5 T's?
pulseless electrical activity (PEA) & asystole
H: hypovolemia, hypoxia, H⁺ ions (acidosis),
hypo/hyperkalemia, hypothermia
T: tension pneumo, tamponade (cardiac), toxins,
thrombosis: cardiac, thrombosis: pulmonary
What is the major difference between cardioversion
and defibrillation?
cardioversion pt has a pulse!
defib = no pulse
What wave should shock be administered during
cardioversion?
What happens if given at wrong time?
MUST be on R wave (use synchronize button)
if shock on T wave (vent depol) will send into V.fib
What is the "Hughes Clue" for determining
treatment of dysrhythmias?
all brady & all blocks have SAME TX!
take quick look at strip, if it's brady who cares what
type, go straight to tx
Torsade de pointes will require what treatments?
(4)
Complete Solutions
Blood drawn from PAC is considered ______
(de/oxygenated).
deoxygenated
think: hasn't gone to the lungs yet, end of catheter
is sitting in the pulmonary artery
,_____ is an amino acid which contributes to
atherosclerosis. This is a _______ (modifiable/non-
modifiable) risk for _______.
homocysteine
modifiable
coronary artery disease
After giving both a diuretic and a positive inotrope,
patient chamber pressures are still high and CI is
low. What is happening?
HF is now accompanied by kidney failure
∵ prolonged poor kidney perfusion, kidneys are too
weak to move fluids out, despite diuretic
At what point during HF would mechanical
interventions be needed?
What are the two options?
if pt doesn't improve after diuretic and 3 positive
inotropes → mechanical intervention
option 1: intra-aortic balloon pump
option 2: ventricular assist device
A reduction of cardiac output causes 2 pathways to
activate
1) SNS stimulation - β stimulation - heart beats
faster - ↑O2 demands - ↑workload to meet O2
demands
2) kidneys activate RAAS - vasoconstriction & Na
,retention - more fluids - ↑workload ∵ heart can't
keep up with more fluids and ↑resistance
What is the "recipe" for interpreting ECG strip?
1) are P waves upright? (if yes: sinus)
2) equal P:QRS ratio?
3) calculate PRI
4) calculate QRS
5) calculate HR
6) name your rhythm
Define the following blocks;
1st degree
2nd degree type I
2nd degree type II
3rd degree
1st: fixed, long PRI & P:QRS
2nd type 1: lengthening PRI then dropped QRS
("longer, longer, longer, drop = Wenckebach")
2nd type 2: fixed PRI, some dropped Qs ("out of
the blue, drop a Q")
3rd: wide QRS, more Ps than Qs (each have
separate, yet fixed schedule)
, What rhythms should you "identify and treat the
cause"? (2)
What are the 5 H's and 5 T's?
pulseless electrical activity (PEA) & asystole
H: hypovolemia, hypoxia, H⁺ ions (acidosis),
hypo/hyperkalemia, hypothermia
T: tension pneumo, tamponade (cardiac), toxins,
thrombosis: cardiac, thrombosis: pulmonary
What is the major difference between cardioversion
and defibrillation?
cardioversion pt has a pulse!
defib = no pulse
What wave should shock be administered during
cardioversion?
What happens if given at wrong time?
MUST be on R wave (use synchronize button)
if shock on T wave (vent depol) will send into V.fib
What is the "Hughes Clue" for determining
treatment of dysrhythmias?
all brady & all blocks have SAME TX!
take quick look at strip, if it's brady who cares what
type, go straight to tx
Torsade de pointes will require what treatments?
(4)
