Complex Med Surg Exam 1 (Cardiac)
questions with correct answers 2024
P wave - Correct AnswersUsually round & upright
0.06 to 0.12 seconds
QRS complex - Correct Answersnormal duration 0.4 to 0.10 (one small box to 2.5 small
boxes)
PR interval - Correct Answersnormal duration 0.12 to 0.20
ST segment - Correct Answersshould be isoelectric
the "J point" should come back to baseline
10 times method - Correct Answerscount the number of R waves in a 6 second strip
and multiply by 10
Big block method - Correct AnswersDivide the number of big boxes between 2
consecutive R waves into 300
Example: 300/4 big boxes = 75 BPM
Potassium levels - Correct Answers3.5 to 5
Calcium levels - Correct Answers9-10.5
Magnesium levels - Correct Answers1.3-2.1
Hyokalemia - Correct AnswersModerate: flat T wave & a U wave
Extreme: prominent U wave
Potassium rich foods - Correct AnswersLean meats
Whole grains
Green leafy vegetables
Potatoes
Beans
Oranges
Bananas
Hyperkalemia - Correct AnswersModerate: Wide flat P / *wide QRS* / *peaked (pointy)
T wave*
Extreme: *no P wave & very wide/wavy QRS*
Hypokalemia Tx - Correct AnswersTx: increase high K+ foods
, IV K+ --> admin slowly, never IV push or admin via IM injection
Hyperkalemia Tx - Correct AnswersSerious incidents may be treated with *sodium
polystyrene sulfonate* & IV diuretics (furosemide)
Emergency interventions might include IV admin of calcium chloride or calcium
gluconate
Hypocalcemia - Correct Answers*Prolonged QT interval r/t prolonged ST segment*
Torsades de Pointes type of V tach may occur
Hypercalcemia - Correct Answers*shortening of the QT interval & ST segment*
PR interval may be prolonged
Dysrhythmia like heart block
Hard to detect DIG tox
Hypomagnesemia - Correct Answers*prolongs QRS & depressed ST segment*
Predisposes to dysrhythmias & dig tox
*Need to correct level to correct hypercalcemia & hypokalemia*
Hypermagnesemia - Correct Answers*prolonged PR interval, tall T waves, a wide QRS,
& prolonged QT interval*
prone to AV blocks
Normal sinus rhythm - Correct AnswersPR interval: 0.12 to 0.20 sec
QRS: 0.04 to 0.10 sec
Sinus tachycardia - Correct Answers>100 BPM
*Common response to pain or decreased CO or BP (dehydration, hypovolemic shock,
MI, HF)*
Tx: underlying cause, not enough blood (first sign ^ HR), meds that stimulate
sympathetic (albuterol, stimulants, illicit drugs)
Sinus bradycardia - Correct Answers< 60BPM
Excess vagal (parasympathetic) stimulation causes decreased HR. May result from
carotid sinus massage, vomiting, suctioning, or drugs (dig, beta blockers), hypoxia, etc.
questions with correct answers 2024
P wave - Correct AnswersUsually round & upright
0.06 to 0.12 seconds
QRS complex - Correct Answersnormal duration 0.4 to 0.10 (one small box to 2.5 small
boxes)
PR interval - Correct Answersnormal duration 0.12 to 0.20
ST segment - Correct Answersshould be isoelectric
the "J point" should come back to baseline
10 times method - Correct Answerscount the number of R waves in a 6 second strip
and multiply by 10
Big block method - Correct AnswersDivide the number of big boxes between 2
consecutive R waves into 300
Example: 300/4 big boxes = 75 BPM
Potassium levels - Correct Answers3.5 to 5
Calcium levels - Correct Answers9-10.5
Magnesium levels - Correct Answers1.3-2.1
Hyokalemia - Correct AnswersModerate: flat T wave & a U wave
Extreme: prominent U wave
Potassium rich foods - Correct AnswersLean meats
Whole grains
Green leafy vegetables
Potatoes
Beans
Oranges
Bananas
Hyperkalemia - Correct AnswersModerate: Wide flat P / *wide QRS* / *peaked (pointy)
T wave*
Extreme: *no P wave & very wide/wavy QRS*
Hypokalemia Tx - Correct AnswersTx: increase high K+ foods
, IV K+ --> admin slowly, never IV push or admin via IM injection
Hyperkalemia Tx - Correct AnswersSerious incidents may be treated with *sodium
polystyrene sulfonate* & IV diuretics (furosemide)
Emergency interventions might include IV admin of calcium chloride or calcium
gluconate
Hypocalcemia - Correct Answers*Prolonged QT interval r/t prolonged ST segment*
Torsades de Pointes type of V tach may occur
Hypercalcemia - Correct Answers*shortening of the QT interval & ST segment*
PR interval may be prolonged
Dysrhythmia like heart block
Hard to detect DIG tox
Hypomagnesemia - Correct Answers*prolongs QRS & depressed ST segment*
Predisposes to dysrhythmias & dig tox
*Need to correct level to correct hypercalcemia & hypokalemia*
Hypermagnesemia - Correct Answers*prolonged PR interval, tall T waves, a wide QRS,
& prolonged QT interval*
prone to AV blocks
Normal sinus rhythm - Correct AnswersPR interval: 0.12 to 0.20 sec
QRS: 0.04 to 0.10 sec
Sinus tachycardia - Correct Answers>100 BPM
*Common response to pain or decreased CO or BP (dehydration, hypovolemic shock,
MI, HF)*
Tx: underlying cause, not enough blood (first sign ^ HR), meds that stimulate
sympathetic (albuterol, stimulants, illicit drugs)
Sinus bradycardia - Correct Answers< 60BPM
Excess vagal (parasympathetic) stimulation causes decreased HR. May result from
carotid sinus massage, vomiting, suctioning, or drugs (dig, beta blockers), hypoxia, etc.
