BKAT 9R EXAMS ALL PAPER ANSWERS AND
QUESTIONS SURE A+
✔✔Indications for nitroprusside/Nipride - ✔✔Causes peripheral vasodilation by acting
on venous and arterial smooth muscle. Decreases BP, SVR, preload, and afterload
therefore increasing CO. Used for HTN, CHF, and hypertensive emergency.
✔✔Dosage of nitroprusside - ✔✔0.5-0.10 mcg/kg/min. Light sensitive. Start with low
dose.
✔✔SE of nitroprusside - ✔✔Make sure there is adequate volume and the BP is above
90. May incompatibilities (can use with nitro & heparin). Can cause thiocyanate toxicity
with higher doses. Monitor for metabolic acidosis. SE: hypotension, HA, nausea, and
vomiting.
✔✔Indications for milrinone/Primacor - ✔✔Positive inotrope with vasoactive activity.
Increases CO and decreases SVR. Used in CHF and to increase CO.
✔✔Dosage of milrinone - ✔✔Bolus (50 mcg/kg over 10 minutes) and then gtt (0.375-
0.75 mcg/kg/min). Precipitates with lasix. Longer half-life. Not titrated.
✔✔SE of milrinone - ✔✔Renal excretion. SE: arrythmias, decreased BP, HA,
hypokalemia
✔✔Indications for nitroglycerin/Nitrostat - ✔✔Direct relaxation of vascular smooth
muscle and vasodilation. Used for HTN, angina, CHF, and MI to decrease O2 demands.
✔✔Dosage of nitroglycerin - ✔✔5-200 mcg/min. Start low. Immediate response.
✔✔SE of nitroglycerin - ✔✔Use with caution for patient dependent on preload for CO
(inferior wall MI or right sided MI). May see tolerance after 24 hours. SE: Hypotension,
reflux tachycardia, HA, flushing, nausea.
✔✔IV antidysrhythmics - ✔✔Atropine = bradycardia
, Lidocaine = VT, ventricular irritability
Amiodarone = afib, VTACH, Vfib
Pronestyl = VTACH, Vfib (can cause torsades)
Verapamil = CA channel block, IV push
Diltiazem = Ca channel blocker, afib, make sure BP good
Adenosine = SLAM IT, SVT, short half-life
✔✔Indications for a pacemaker - ✔✔Treat sudden cardiac death, EF < 35%, sustained
VT, refractory HF despite optimal medical management
✔✔Problems with pacemakers - ✔✔Failure to capture, over sensing, and under sensing
✔✔Signs and symptoms of cardiac tamponade - ✔✔Rise in filling pressure with
decreased CO & hypotension. CVP=PAOP=PAD. Sudden drop in bleeding. Narrowing
pulse pressure. Tachycardia, dysrhythmias, decreased ECG voltage. Decreased UOP.
Anxiety and restlessness. Low blood pressure and weakness. Chest pain radiating to
neck, shoulders, or back. Trouble breathing or taking deep breaths. Rapid breathing.
Discomfort that is relieved by sitting or leaning forward.
✔✔Postoperative care of chest tubes - ✔✔Assess q15 for first few hours to monitor
drainage changes. Output to average ~100 cc/hr and should gradually decrease.
Average is a total of 1L output. Chest tubes are removed when total drainage is < 100
ml for 8 hours. If output > 100 ml/hr then order PT, PTT, and platelets.
✔✔Purpose of Swan (PA) catheter - ✔✔Measure vascular capacity, blood volume,
pump effectiveness, and tissue perfusion.
✔✔Visual of PA catheter waveforms - ✔✔
✔✔Normal CVP/RAP - ✔✔1-8 mm Hg
✔✔Normal PAWP/LVEDP (left ventricular end diastolic pressure) - ✔✔4-12 mm Hg
✔✔Normal PAP - ✔✔Systolic: 15-25 mm Hg
Diastolic: 6-12 mm Hg
✔✔If PAWP is low? - ✔✔Hypovolemia
✔✔If PAWP is elevated? - ✔✔Hypervolemia and indicative of left ventricular failure.
✔✔Normal CO - ✔✔4-8 L/min
✔✔Normal SVO2 - ✔✔60-80% O2 into lungs
QUESTIONS SURE A+
✔✔Indications for nitroprusside/Nipride - ✔✔Causes peripheral vasodilation by acting
on venous and arterial smooth muscle. Decreases BP, SVR, preload, and afterload
therefore increasing CO. Used for HTN, CHF, and hypertensive emergency.
✔✔Dosage of nitroprusside - ✔✔0.5-0.10 mcg/kg/min. Light sensitive. Start with low
dose.
✔✔SE of nitroprusside - ✔✔Make sure there is adequate volume and the BP is above
90. May incompatibilities (can use with nitro & heparin). Can cause thiocyanate toxicity
with higher doses. Monitor for metabolic acidosis. SE: hypotension, HA, nausea, and
vomiting.
✔✔Indications for milrinone/Primacor - ✔✔Positive inotrope with vasoactive activity.
Increases CO and decreases SVR. Used in CHF and to increase CO.
✔✔Dosage of milrinone - ✔✔Bolus (50 mcg/kg over 10 minutes) and then gtt (0.375-
0.75 mcg/kg/min). Precipitates with lasix. Longer half-life. Not titrated.
✔✔SE of milrinone - ✔✔Renal excretion. SE: arrythmias, decreased BP, HA,
hypokalemia
✔✔Indications for nitroglycerin/Nitrostat - ✔✔Direct relaxation of vascular smooth
muscle and vasodilation. Used for HTN, angina, CHF, and MI to decrease O2 demands.
✔✔Dosage of nitroglycerin - ✔✔5-200 mcg/min. Start low. Immediate response.
✔✔SE of nitroglycerin - ✔✔Use with caution for patient dependent on preload for CO
(inferior wall MI or right sided MI). May see tolerance after 24 hours. SE: Hypotension,
reflux tachycardia, HA, flushing, nausea.
✔✔IV antidysrhythmics - ✔✔Atropine = bradycardia
, Lidocaine = VT, ventricular irritability
Amiodarone = afib, VTACH, Vfib
Pronestyl = VTACH, Vfib (can cause torsades)
Verapamil = CA channel block, IV push
Diltiazem = Ca channel blocker, afib, make sure BP good
Adenosine = SLAM IT, SVT, short half-life
✔✔Indications for a pacemaker - ✔✔Treat sudden cardiac death, EF < 35%, sustained
VT, refractory HF despite optimal medical management
✔✔Problems with pacemakers - ✔✔Failure to capture, over sensing, and under sensing
✔✔Signs and symptoms of cardiac tamponade - ✔✔Rise in filling pressure with
decreased CO & hypotension. CVP=PAOP=PAD. Sudden drop in bleeding. Narrowing
pulse pressure. Tachycardia, dysrhythmias, decreased ECG voltage. Decreased UOP.
Anxiety and restlessness. Low blood pressure and weakness. Chest pain radiating to
neck, shoulders, or back. Trouble breathing or taking deep breaths. Rapid breathing.
Discomfort that is relieved by sitting or leaning forward.
✔✔Postoperative care of chest tubes - ✔✔Assess q15 for first few hours to monitor
drainage changes. Output to average ~100 cc/hr and should gradually decrease.
Average is a total of 1L output. Chest tubes are removed when total drainage is < 100
ml for 8 hours. If output > 100 ml/hr then order PT, PTT, and platelets.
✔✔Purpose of Swan (PA) catheter - ✔✔Measure vascular capacity, blood volume,
pump effectiveness, and tissue perfusion.
✔✔Visual of PA catheter waveforms - ✔✔
✔✔Normal CVP/RAP - ✔✔1-8 mm Hg
✔✔Normal PAWP/LVEDP (left ventricular end diastolic pressure) - ✔✔4-12 mm Hg
✔✔Normal PAP - ✔✔Systolic: 15-25 mm Hg
Diastolic: 6-12 mm Hg
✔✔If PAWP is low? - ✔✔Hypovolemia
✔✔If PAWP is elevated? - ✔✔Hypervolemia and indicative of left ventricular failure.
✔✔Normal CO - ✔✔4-8 L/min
✔✔Normal SVO2 - ✔✔60-80% O2 into lungs
