Northwestern State University NURB 4120 critical care test
one Questions With Complete Solutions
#1 complications of PCI and what to do Correct Answers
dysrythmias- 2/3rds are v tach- POP EM
3 critical questions to ask when there is a problem Correct
Answers how is my patient, do I need to treat this (how), and
what is causing it (cause may determine treatment)
5 step analyzing for rhythms Correct Answers rate, rhythm,
P;QRS ratio, QT length, PR interval
abgs during pulm edema Correct Answers alkaline early on
with PCO2 less than 35 because trying to breathe fast, but as
lungs fill they become acidodic with pco2 greater than 35 and o2
less than 90
acute coronary syndrome Correct Answers deterioration of a
once stable plaque in artery, plaque ruptures, platelets aggregate,
thrombus forms, ischemia is prolonged and not immediately
reversible
if partial it results in unstable angina, if total results in an MI
amiodarone drip for a flutter Correct Answers start at 1 mg for
6 hr, then 0.5 mg an hour
Anterior descending coronary artery supplies what Correct
Answers left ventricle. Anterior MI can lead to pump failure,
flash pulmonary edema
,biggest lab to check if patient on warfarin Correct Answers
INR
cardiomyopathy Correct Answers disease of the heart muscle,
can be primary (idiopathic) or secondary from CAD/HTN/etoh
abuse/peripartum known autoimmune
cardioversion Correct Answers synch with the r wave,
consider sedation, can dislodge a clot causing a CVA so need
baseline neuro and neuro checks after to compare
cardioversion directions Correct Answers delivers large dose
of electricity- must sync with the R wave, use for v tach with a
pulse
care post heart cath Correct Answers watch for bleeding,
reinforce dressing, direct pressure, look at back for bleeding,
report a wet or warm sensation, paresthesias, fever, keep leg
straight for 6-8 hours
causes and treatment for PSVT? Correct Answers caffeine,
anxiety, fever, etc,
treatment- vagal, if unstable give drugs or cardioversion
get them to cough or bear down
give CCBs, BBs, digoxin, adinosine (6 mg, then 12 if the
conversion isn't normal )
causes and treatment of a flutter Correct Answers s/p cabbage,
caffeine, medications, structural defects
worry about clots- blood thinners, amiodarone is 1mg/hr for 6h,
then 0.5mg/hr
, causes of a type on heart block Correct Answers MI, drugs,
heart dx
circumflex artery supplies what side of heart Correct Answers
left lateral
complete heart block Correct Answers looks like PVCs with p
waves marching through, rate is 40-60, from MI, dig, age, s/p
CABG, need atropine (0.5-1mg/kg/hr), dopamine to increase Hr
and blood pressure, pacemaker
complications of a complete blockage in the heart Correct
Answers stroke, artery rutpure, heart attack elsewhere,
dysrhythmias, abrupt closure, allergic reaction to dye, dissection
of artery or rupture,may need CABG
critical thinking and nursing actions for abnormal rhythms?
Correct Answers how is the patient?, are they symptomatic?,
any changes in VS, LOC?, Intervention Needed? can call HCP,
call code, What is causing it? follow ACLS
definition of afterload and ways to evaluate Correct Answers
resistance the heart pumps against, measure with BP, MAPs,
SVR
definition of preload Correct Answers pressure of blood before
systole
depolarization Correct Answers going up on curve- sodium
and Potassium switching, steep increase
one Questions With Complete Solutions
#1 complications of PCI and what to do Correct Answers
dysrythmias- 2/3rds are v tach- POP EM
3 critical questions to ask when there is a problem Correct
Answers how is my patient, do I need to treat this (how), and
what is causing it (cause may determine treatment)
5 step analyzing for rhythms Correct Answers rate, rhythm,
P;QRS ratio, QT length, PR interval
abgs during pulm edema Correct Answers alkaline early on
with PCO2 less than 35 because trying to breathe fast, but as
lungs fill they become acidodic with pco2 greater than 35 and o2
less than 90
acute coronary syndrome Correct Answers deterioration of a
once stable plaque in artery, plaque ruptures, platelets aggregate,
thrombus forms, ischemia is prolonged and not immediately
reversible
if partial it results in unstable angina, if total results in an MI
amiodarone drip for a flutter Correct Answers start at 1 mg for
6 hr, then 0.5 mg an hour
Anterior descending coronary artery supplies what Correct
Answers left ventricle. Anterior MI can lead to pump failure,
flash pulmonary edema
,biggest lab to check if patient on warfarin Correct Answers
INR
cardiomyopathy Correct Answers disease of the heart muscle,
can be primary (idiopathic) or secondary from CAD/HTN/etoh
abuse/peripartum known autoimmune
cardioversion Correct Answers synch with the r wave,
consider sedation, can dislodge a clot causing a CVA so need
baseline neuro and neuro checks after to compare
cardioversion directions Correct Answers delivers large dose
of electricity- must sync with the R wave, use for v tach with a
pulse
care post heart cath Correct Answers watch for bleeding,
reinforce dressing, direct pressure, look at back for bleeding,
report a wet or warm sensation, paresthesias, fever, keep leg
straight for 6-8 hours
causes and treatment for PSVT? Correct Answers caffeine,
anxiety, fever, etc,
treatment- vagal, if unstable give drugs or cardioversion
get them to cough or bear down
give CCBs, BBs, digoxin, adinosine (6 mg, then 12 if the
conversion isn't normal )
causes and treatment of a flutter Correct Answers s/p cabbage,
caffeine, medications, structural defects
worry about clots- blood thinners, amiodarone is 1mg/hr for 6h,
then 0.5mg/hr
, causes of a type on heart block Correct Answers MI, drugs,
heart dx
circumflex artery supplies what side of heart Correct Answers
left lateral
complete heart block Correct Answers looks like PVCs with p
waves marching through, rate is 40-60, from MI, dig, age, s/p
CABG, need atropine (0.5-1mg/kg/hr), dopamine to increase Hr
and blood pressure, pacemaker
complications of a complete blockage in the heart Correct
Answers stroke, artery rutpure, heart attack elsewhere,
dysrhythmias, abrupt closure, allergic reaction to dye, dissection
of artery or rupture,may need CABG
critical thinking and nursing actions for abnormal rhythms?
Correct Answers how is the patient?, are they symptomatic?,
any changes in VS, LOC?, Intervention Needed? can call HCP,
call code, What is causing it? follow ACLS
definition of afterload and ways to evaluate Correct Answers
resistance the heart pumps against, measure with BP, MAPs,
SVR
definition of preload Correct Answers pressure of blood before
systole
depolarization Correct Answers going up on curve- sodium
and Potassium switching, steep increase
