Nur 245 Exam 1 ACTUAL QUESTIONS
AND CORRECT ANSWERS
Sinus Bradycardia - CORRECT ANSWER SA node fires at a rate less than 60
- symptomatic: fatigue, dizziness, chest pain, syncope, pale/cool skin, hypotension, weakness,
confusion, disorientation, SOB
drugs* BB, CCB
*may be normal in athletes and some people during sleep
Sinus Bradycardia Treatment - CORRECT ANSWER treat patient with symptoms
- give O2
*IV atropine
if atropine is ineffective, PACING, or dopamine/epinephrine (adrenalin) infusion is considered
if d/t drugs, may have to hold, d/c, and decrease
Sinus Tachycardia - CORRECT ANSWER *dizziness, dyspnea, hypotension bc of - decreased
CO = increased myocardial O2 consumption
CAD = angina
discharge rate from the SA node increased bc of vagal inhibition or sympathetic stimulation
rate 101-200
can be caused from fever, pain, hypotension, hypovalemia, anemia, hypoxia, hypoglycemia, MI, HF,
hypothyroidism, anxiety, fear
- drugs; EPI, NOR-EPI, atropine, caffeine, theophylline, hydralazine
OTC - Sudafed
Sinus Tachycardia Treatment - CORRECT ANSWER *treat underlying cause
stable pt = vagal maneuver, BB, adenosine, CCB - to decrease HR
unstable pt = cardioversion
Atrial Flutter - CORRECT ANSWER recurring, regular, narrow, sawtoothed shaped flutter
*CAD, HTN
,rate = 200-350
PR variable no measureable
QRS normal
*Increase risk of stroke = give Coumadin
Atrial Flutter Treatment - CORRECT ANSWER goal* slow ventricular rate response by
increasing AV block
control ventricular rate with BB, CCB
- electronical cardioversion may be done to convert to NSR in an emergency
*antidysrhythmics = amiodarone, flecainide, dronedarone
Atrial Fibrillation (A-Fib) - CORRECT ANSWER total disorganization of atrial electricity
rate 350-600
no P waves, IRREGULAR rhythm
- decreased CO, thrombi form in atria = STROKE
Atrial Fibrillation (A-Fib) Treatment - CORRECT ANSWER goal* decrease ventricular
response to less than 100, prevention of stroke, conversion to SR if possible.
drugs for ventricular rate control* CCD, BB, dronedarone, and digoxin
Digoxin (decreased heart rate) - CORRECT ANSWER *used for patients with AFIB
1.5-2.5
- hypokalemia = major cause of toxicity
monitor for hypo or hyperkalemia
EARLY = anorexia, N/V, fatigue, HA, depression, visual changes
LATE = dysrhythmias, bradycardia, AV block
PVC - CORRECT ANSWER premature ventricular contraction
early occurance of a QRS
- wide and distorted in shape
VT occurs when there are 3 or more consecutives PVC's
, *caffeine, alcohol, aminophylline, EPI, digoxin, isoproterenol, electrolyte imbalance, hypoxia, fever,
exercise, stress
PVC Treatment - CORRECT ANSWER check O2 = can be r/t hypoxia
check K+= electrolyte imbalance
- assess hemodynamic status
drugs*BB, procainamide, or amiodarone
Ventricular Tachycardia - CORRECT ANSWER a run of 3 or more PVC/s
*life threatening, decrease CO, and possible development of V-FIB
rate 50-200
WIDE, bizarre QRS (>0.12)
*electrolyte imbalance, ischemia
Ventricular Tachycardia Treatment - CORRECT ANSWER asses pulse
No pulse = life threatening
*CPR and rapid defibrillation
followed by EPI and Amiodarone if defibrillation is unsuccessful
Ventricular fibrillation (V-fib) - CORRECT ANSWER IRREGULAR waveforms of varying
shapes
- acute MI and HR
*HR not measurable, rhythm irregular and chaotic
NO P wave, QRS not measurable
Ventricular fibrillation (V-fib) Treatment - CORRECT ANSWER *CPR, ACLS, Defibrillation
*EPI
Asystole - CORRECT ANSWER CPR, ACLS, EPI
CVP - CORRECT ANSWER how much volume is in the right atrium
AND CORRECT ANSWERS
Sinus Bradycardia - CORRECT ANSWER SA node fires at a rate less than 60
- symptomatic: fatigue, dizziness, chest pain, syncope, pale/cool skin, hypotension, weakness,
confusion, disorientation, SOB
drugs* BB, CCB
*may be normal in athletes and some people during sleep
Sinus Bradycardia Treatment - CORRECT ANSWER treat patient with symptoms
- give O2
*IV atropine
if atropine is ineffective, PACING, or dopamine/epinephrine (adrenalin) infusion is considered
if d/t drugs, may have to hold, d/c, and decrease
Sinus Tachycardia - CORRECT ANSWER *dizziness, dyspnea, hypotension bc of - decreased
CO = increased myocardial O2 consumption
CAD = angina
discharge rate from the SA node increased bc of vagal inhibition or sympathetic stimulation
rate 101-200
can be caused from fever, pain, hypotension, hypovalemia, anemia, hypoxia, hypoglycemia, MI, HF,
hypothyroidism, anxiety, fear
- drugs; EPI, NOR-EPI, atropine, caffeine, theophylline, hydralazine
OTC - Sudafed
Sinus Tachycardia Treatment - CORRECT ANSWER *treat underlying cause
stable pt = vagal maneuver, BB, adenosine, CCB - to decrease HR
unstable pt = cardioversion
Atrial Flutter - CORRECT ANSWER recurring, regular, narrow, sawtoothed shaped flutter
*CAD, HTN
,rate = 200-350
PR variable no measureable
QRS normal
*Increase risk of stroke = give Coumadin
Atrial Flutter Treatment - CORRECT ANSWER goal* slow ventricular rate response by
increasing AV block
control ventricular rate with BB, CCB
- electronical cardioversion may be done to convert to NSR in an emergency
*antidysrhythmics = amiodarone, flecainide, dronedarone
Atrial Fibrillation (A-Fib) - CORRECT ANSWER total disorganization of atrial electricity
rate 350-600
no P waves, IRREGULAR rhythm
- decreased CO, thrombi form in atria = STROKE
Atrial Fibrillation (A-Fib) Treatment - CORRECT ANSWER goal* decrease ventricular
response to less than 100, prevention of stroke, conversion to SR if possible.
drugs for ventricular rate control* CCD, BB, dronedarone, and digoxin
Digoxin (decreased heart rate) - CORRECT ANSWER *used for patients with AFIB
1.5-2.5
- hypokalemia = major cause of toxicity
monitor for hypo or hyperkalemia
EARLY = anorexia, N/V, fatigue, HA, depression, visual changes
LATE = dysrhythmias, bradycardia, AV block
PVC - CORRECT ANSWER premature ventricular contraction
early occurance of a QRS
- wide and distorted in shape
VT occurs when there are 3 or more consecutives PVC's
, *caffeine, alcohol, aminophylline, EPI, digoxin, isoproterenol, electrolyte imbalance, hypoxia, fever,
exercise, stress
PVC Treatment - CORRECT ANSWER check O2 = can be r/t hypoxia
check K+= electrolyte imbalance
- assess hemodynamic status
drugs*BB, procainamide, or amiodarone
Ventricular Tachycardia - CORRECT ANSWER a run of 3 or more PVC/s
*life threatening, decrease CO, and possible development of V-FIB
rate 50-200
WIDE, bizarre QRS (>0.12)
*electrolyte imbalance, ischemia
Ventricular Tachycardia Treatment - CORRECT ANSWER asses pulse
No pulse = life threatening
*CPR and rapid defibrillation
followed by EPI and Amiodarone if defibrillation is unsuccessful
Ventricular fibrillation (V-fib) - CORRECT ANSWER IRREGULAR waveforms of varying
shapes
- acute MI and HR
*HR not measurable, rhythm irregular and chaotic
NO P wave, QRS not measurable
Ventricular fibrillation (V-fib) Treatment - CORRECT ANSWER *CPR, ACLS, Defibrillation
*EPI
Asystole - CORRECT ANSWER CPR, ACLS, EPI
CVP - CORRECT ANSWER how much volume is in the right atrium
