PCCN CARDIAC ACTUAL FINALS SET QUESTIONS
AND ANSWERS SET A+
✔✔SV - ✔✔amount ejected with each beat
✔✔EF - ✔✔amount pumped with each contraction in relation to the amount available
>60%
✔✔Preload - ✔✔-Stretch of myocardial fibers just before contraction (end-diastolic
volume); influenced by blood volume to right side of heart..More stretch= more force
Combination of volume entering LV and the contractility of the ventricle (L Ventricular
end diastolic pressure/LVEDP) Measured with Pulmonary artery cath and pulmonary
cap wedge pressure. Effected by venous return, total blood volume, atrial tick and
compliance of the ventricals
✔✔afterload - ✔✔Pressure or resistance against which the ventricles must pump to
eject blood (SVR, Viscosity and valves, aortic stenosis. Goals for reducing include
decreasing SVR with vasodialtors, reducing blood volume or fix defect
✔✔BP - ✔✔CO+SVR---late show
✔✔Central venous pressure - ✔✔Central Venous Pressur, (CVP) THE PRESSURE
WITHIN THE SUPERIOR VENA CAVA; IT REFLECTS THE PRESSURE UNDER
WHICH THE BLOOD IS RETURNED TO THE RIGHT ATRIUM. shows how R Vent
doing NORMAL 8-12 (high-HF/fluid overload) Low=hypovolemia
✔✔Myocardial infarction - ✔✔Hear attack occurs due to lack of blood flow through the
coronary arteries to the heart muscle. Longer than 30 min, not relieved by nitro
✔✔MI initial ekg changes - ✔✔T wave inversion, followed quickly by ST elevation in
effective areas
, ✔✔Inferior MI - ✔✔RCA. Lower mortality.Mild AV node dysrhythmias (1avbor 2avb type
1)
Up to 40% of patients with an inferior STEMI will have a concomitant right ventricular
infarction. These patients may develop severe hypotension in response to nitrates and
generally have a worse prognosis.
Up to 20% of patients with inferior STEMI will develop significant bradycardia due to
second- or third-degree AV block. These patients have an increased in-hospital
mortality (>20%).
Inferior STEMI may also be associated with posterior infarction, which confers a worse
prognosis due to increased area of myocardium at risk. leads v1-v4
*******ST elevation in leads II, III and aVF
Progressive development of Q waves in II, III and aVF
Reciprocal ST depression in aVL (± lead I)********
✔✔Anterior MI - ✔✔Left anterior decending, more serious (2nd and 3rd AVB)
diminished EF and symptoms of HF
****q waves, st elevation in v2-v4. Reciprocal changes in leads 2,3, and avf
✔✔Lateral MI - ✔✔Qwaves, ST elevation 1, aVl, V5, V6
Circumflex artery
✔✔Posterior Mi - ✔✔Large R waves V1, V2.. Reflected on opposite walls, opposite
deflections
✔✔anterolateral MI - ✔✔multiple areas
✔✔RV MI - ✔✔ST elevation in II, II and aVF. Right sided EKG will show STEMI in v3,
v...elevated CVP
✔✔PCI indication - ✔✔symptom onset <12 hours, Cardiogenic shock, hemodynaic or
electical instaaility
✔✔Thrombolytic theraphy - ✔✔ST elevation or LBBB, clear indicators of Mi..3-6 hours
of onset if pt can not get to cath lab in 90 min..re-perfusion dysrhytmias
✔✔Occlusion of right coronary artery - ✔✔Supplies right ventrical or inferior portion of
the heart
✔✔Where do you listen for apical pluse - ✔✔left 5 ICS midclavicular line. Location of left
ventrical apex( maximum impulse) 2nd ISC Midclavicular line is plumonic
✔✔Secific treatments for inferior wall MI - ✔✔fluids, inoropics, afterload reducing
medications
AND ANSWERS SET A+
✔✔SV - ✔✔amount ejected with each beat
✔✔EF - ✔✔amount pumped with each contraction in relation to the amount available
>60%
✔✔Preload - ✔✔-Stretch of myocardial fibers just before contraction (end-diastolic
volume); influenced by blood volume to right side of heart..More stretch= more force
Combination of volume entering LV and the contractility of the ventricle (L Ventricular
end diastolic pressure/LVEDP) Measured with Pulmonary artery cath and pulmonary
cap wedge pressure. Effected by venous return, total blood volume, atrial tick and
compliance of the ventricals
✔✔afterload - ✔✔Pressure or resistance against which the ventricles must pump to
eject blood (SVR, Viscosity and valves, aortic stenosis. Goals for reducing include
decreasing SVR with vasodialtors, reducing blood volume or fix defect
✔✔BP - ✔✔CO+SVR---late show
✔✔Central venous pressure - ✔✔Central Venous Pressur, (CVP) THE PRESSURE
WITHIN THE SUPERIOR VENA CAVA; IT REFLECTS THE PRESSURE UNDER
WHICH THE BLOOD IS RETURNED TO THE RIGHT ATRIUM. shows how R Vent
doing NORMAL 8-12 (high-HF/fluid overload) Low=hypovolemia
✔✔Myocardial infarction - ✔✔Hear attack occurs due to lack of blood flow through the
coronary arteries to the heart muscle. Longer than 30 min, not relieved by nitro
✔✔MI initial ekg changes - ✔✔T wave inversion, followed quickly by ST elevation in
effective areas
, ✔✔Inferior MI - ✔✔RCA. Lower mortality.Mild AV node dysrhythmias (1avbor 2avb type
1)
Up to 40% of patients with an inferior STEMI will have a concomitant right ventricular
infarction. These patients may develop severe hypotension in response to nitrates and
generally have a worse prognosis.
Up to 20% of patients with inferior STEMI will develop significant bradycardia due to
second- or third-degree AV block. These patients have an increased in-hospital
mortality (>20%).
Inferior STEMI may also be associated with posterior infarction, which confers a worse
prognosis due to increased area of myocardium at risk. leads v1-v4
*******ST elevation in leads II, III and aVF
Progressive development of Q waves in II, III and aVF
Reciprocal ST depression in aVL (± lead I)********
✔✔Anterior MI - ✔✔Left anterior decending, more serious (2nd and 3rd AVB)
diminished EF and symptoms of HF
****q waves, st elevation in v2-v4. Reciprocal changes in leads 2,3, and avf
✔✔Lateral MI - ✔✔Qwaves, ST elevation 1, aVl, V5, V6
Circumflex artery
✔✔Posterior Mi - ✔✔Large R waves V1, V2.. Reflected on opposite walls, opposite
deflections
✔✔anterolateral MI - ✔✔multiple areas
✔✔RV MI - ✔✔ST elevation in II, II and aVF. Right sided EKG will show STEMI in v3,
v...elevated CVP
✔✔PCI indication - ✔✔symptom onset <12 hours, Cardiogenic shock, hemodynaic or
electical instaaility
✔✔Thrombolytic theraphy - ✔✔ST elevation or LBBB, clear indicators of Mi..3-6 hours
of onset if pt can not get to cath lab in 90 min..re-perfusion dysrhytmias
✔✔Occlusion of right coronary artery - ✔✔Supplies right ventrical or inferior portion of
the heart
✔✔Where do you listen for apical pluse - ✔✔left 5 ICS midclavicular line. Location of left
ventrical apex( maximum impulse) 2nd ISC Midclavicular line is plumonic
✔✔Secific treatments for inferior wall MI - ✔✔fluids, inoropics, afterload reducing
medications
