NURS 420- Quiz #1 Exam Questions With Complete Solutions

NURS 420- Quiz #1 Exam Questions With Complete Solutions a wide QRS is defined as - answergreater than .12 sec Conduction system of the heart - answerSA node, AV node, bundle of His, r and l bundle branches, and Purkinje fibers What is the P wave of an ECG? - answeratrial depolarization What is the QRS complex of an ECG? - answerventricular depolarization and atrial repolarization What is the T wave of an ECG? - answerventricular repolarization PR interval - answerdelay of AV node to allow filling of ventricles/ 0.12-.20 sec QRS interval - answer0.12 1 box on EKG strip = ___ sec - answer0.2 P wave should be ________, _______ than QRS. QRS should be _________ and ___ wave will follow - answerupright, smaller, narrow, T what does the U wave represent? - answerrepolarization of the purkinje fibers where do sinus rhythms originate? - answerSA node normal sinus rhythm (NSR) - answereverythings at baseline/ R-R equidistant Sinus Bradycardia - answer<60 bpm Sinus Tachycardia - answer>100 bpm what is a dysrhythmia? - answer•Uncharacteristic heart rate or rhythm. •Heart beats too fast, too slow, and/or out of sync what may a dysrhythmia result in? - answerinadequate BP, tissue perfusion, and other complications specific to the dysrhythmia what is atrial flutter? - answerResults from a re-entrant circuit in the atria that generates flutter waves, usually at a rate of 250 - 350 per minute. what kind of pattern is indicative of a flutter? - answersawtooth d/t atria beating way faster than ventricles What is atrial fibrillation? - answerdisorganized electrical signals leading to atria just jiggling, vibrating/ no distinguishable P waves what risk does a fib cause? - answerclot formation and emboli d/t blood stasis what impacts CO in afib? - answertachy rate or rapid ventricular rate steps to take for a pt w a fib w rapid ventricular response (RVR)? - answer•Amiodarone (antidysrhythmic) for rate and rhythm control. •May also use beta blocker, digoxin to slow HR and control beats •Synchronized cardioversion •Anti-platelet & anticoagulant meds what do you want in therapeutic level before synchronized cardioversion? - answerPT, PTT so you don't send emboli out if a. fib w RVR doesn't convert, we will need to? - answercontrol rate and coagulability to limit clot formation what is an AV block? - answerDiminished or eliminated conduction from atria to ventricles/ p wave but no QRST what are the most common causes of AV blocks in about 50% of pts? 40%? 10%? - answerheart disease causing fibrosis and sclerosis of the conduction system/ ischemic heart disease/ drug related: digoxin, beta blockers whats a common tx for AV blocks? another tx? - answerpacemaker implantation/ med adjustment how can digoxin cause an AV block? - answerslows conduction through AV node What's a premature ventricular contraction (PVC)? - answernot particularly concerning/ signal from ventricle comes before P wave (before SA node sends signal) when do PVCs become more of a concern? - answerwhen they become more freq and organized couplet PVCs - answer2 PVCs in a row triplet PVCs - answerOccur in groups of three Trigeminy PVCs - answerevery third beat is a PVC Bigeminy PVC - answerevery other beat is a PVC multifocal PVC - answerinc excitability in ventricles Ventricular tachycardia (V-tach) - answercan be pulseless or pulse V-Tach with pulse Immediate ATTN •Maintain an _____ _______- Asst resp as needed •Monitor cardiac ______, ______, blood__________ •Supplemental oxygen to maintain O2 >___% •IV access - __________, calcium channel blockers and beta blockers, to ____ HR - answeropen airway rhythm, BP, oxygenation 94 antidysrhythmics, slow what's the immediate intervention for pulseless v tach? why is someone pulseless? - answer•Synchronized cardioversion per ACLS protocol/ hearts beating so fast their not perfusing what will happen if vtach is left untx? - answerconvert to v fib ventricular fibrillation - answerabnormally fast and chaotic heart rate: ventricles quiver rather than beat/ no QRS v fib immediate action •Initiate _____ •________ immediately with __________ per ACLS protocol - ___ shocks •Administer ________ and _______ per ACLS protocol •Monitor cardiac______, ____, ____ sat - answerCPR shock, defibrillator, 3 EPI, amiodarone rhythm, BP, O2 Idioventricular Rhythms - answerOnly purkinje fibers firing WIDE QRS always/ accelerated and agonal Pulseless Electrical Activity (PEA) - answercondition in which electrical activity is present on an electrocardiogram, but there is not an adequate pulse or blood pressure Asystole - answerabsence of contractions of the heart what are some causes for dysrhythmias? - answer•Age-related cardiac damage •CAD, heart disease or heart attack •A complication of heart surgery •Thyroid disease •Obstructive sleep apnea what meds cause brady-dysrhythmias? - answer•Medications such as sedatives, opioids, or cardiac meds like digoxin, beta-blockers (brady-dysrhythmias) what meds cause tachy-dysrhythmias? - answer•Nicotine and illegal drugs, such as amphetamines and cocaine (tachy-dysrhythmias) what are some s/sx of dysrhythmias? - answer•Palpita