NUR 431 L FINAL EXAM QUESTIONS
AND ANSWERS
Clues: flat T waves, diuretic use
Treatment: replete K+ - Answer-Hypokalemia
Clues: peaked T waves, small P waves, history of renal failure, diabetes
Treatment: Kayexalate, glucose and insulin, calcium chloride, NaBicarb - Answer-
Hyperkalemia
Clues: cyanosis, blood gases, airway issues
Treatment: Oxygenate, ventilate, advanced airway - Answer-Hypoxia
Clues: possible prolongation of QT interval, bradycardia, empty bottles at scene, pupils
or neurologic exam
Treatment: Drug screen, lavage, antidotes, activated charcoal - Answer-Toxins
For acute coronary syndrome you want to do: - Answer-M: morphine
O: oxygen
N: Nitro
A: Aspirin
Indications: SVT, narrow complex tachycardia, or regular monomorphic wide complex
tachycardia
Dose:
6 mg IV/IO for first dose
12 mg IV/IO for 2nd and 3rd doses - Answer-Adenosine
Indications: V-Fib or pulseless V-tach
Dose:
300 mg IV/IO for first dose
150 mg IV/IO 2nd dose - Answer-Amiodarone
Indications: V-tach with a pulse
Dose:
150 mg over 10 minutes (rapid)
Maintenance infusion: 1 mg/min for 6 hours (slow) - Answer-Amiodarone
Indications: Bradycardia
Dose: 0.5 mg IV/IO q 3-5 minutes PRN (max 3 mg) - Answer-Atropine
Indications: A-fib or A-flutter
Dose: 15-20 mg IV over 2 minutes - Answer-Diltiazem (calcium-channel blocker)
, Indications: V-fib, pulseless V-tach, PEA, Asystole, Symptomatic bradycardia
Dose:
1 mg IV/IO q 3-5 minutes
Infusion: 2-10 mcg/min (bradycardia)
0.1-0.5 mcg/kg/min (ROSC) - Answer-Epi
Indications: angina
Dose: 0.3-0.6 mg SL q 5 minutes (max 3 doses w/in 15 min) - Answer-Nitro
Indications: V-tach (monomorphic: stable, wide QRS tachycardia)
Dose:
20-50 mg/min until arrhythmia subsides, hypotension occurs, QRS increased by 50%,
or maximum dose of 17 mg/kg
Maintenance infusion: 1-4 mg/min - Answer-Procainimide (Anti-arrythmic)
FOLLOW IV MEDS WITH A ___CC SALINE FLUSH AND ELEVATE EXTREMITY TO
FACILITATE CIRCULATION OF MEDICATION - Answer-20
Centrally inserted catheter, or central venous catheters (CVC) rests in the distal end of
the ____ near the junction with the ___ - Answer-superior vena cava, right atrium
60-100 bpm (normal pacemaker) - Answer-SA node
40-60 bpm - Answer-AV node
20-40 bpm - Answer-Purkinje fibers
indications for _________
Severe Bradycardia with hemodynamic instability- Not responsive to Atropine
Symptomatic Bradycardia
High degree of Heart Block
Sinus Arrest - Answer-cardiac pacing
Pacing the atrium because it is right before p wave which represents atrium
20% of cardiac output in generated in atrium - Answer-Single chamber pacing
Causes:
Loose hookups
Dead battery
Malfunctioning pulse generator - Answer-Failure to fire
Clues: renal failure
Treatment: Sodium Bicarbonate, hyperventilate - Answer-Hydrogen ion (acidosis)
Clues: neck vein distention, tracheal deviation, unequal breath sounds, difficulty
ventilating patient
AND ANSWERS
Clues: flat T waves, diuretic use
Treatment: replete K+ - Answer-Hypokalemia
Clues: peaked T waves, small P waves, history of renal failure, diabetes
Treatment: Kayexalate, glucose and insulin, calcium chloride, NaBicarb - Answer-
Hyperkalemia
Clues: cyanosis, blood gases, airway issues
Treatment: Oxygenate, ventilate, advanced airway - Answer-Hypoxia
Clues: possible prolongation of QT interval, bradycardia, empty bottles at scene, pupils
or neurologic exam
Treatment: Drug screen, lavage, antidotes, activated charcoal - Answer-Toxins
For acute coronary syndrome you want to do: - Answer-M: morphine
O: oxygen
N: Nitro
A: Aspirin
Indications: SVT, narrow complex tachycardia, or regular monomorphic wide complex
tachycardia
Dose:
6 mg IV/IO for first dose
12 mg IV/IO for 2nd and 3rd doses - Answer-Adenosine
Indications: V-Fib or pulseless V-tach
Dose:
300 mg IV/IO for first dose
150 mg IV/IO 2nd dose - Answer-Amiodarone
Indications: V-tach with a pulse
Dose:
150 mg over 10 minutes (rapid)
Maintenance infusion: 1 mg/min for 6 hours (slow) - Answer-Amiodarone
Indications: Bradycardia
Dose: 0.5 mg IV/IO q 3-5 minutes PRN (max 3 mg) - Answer-Atropine
Indications: A-fib or A-flutter
Dose: 15-20 mg IV over 2 minutes - Answer-Diltiazem (calcium-channel blocker)
, Indications: V-fib, pulseless V-tach, PEA, Asystole, Symptomatic bradycardia
Dose:
1 mg IV/IO q 3-5 minutes
Infusion: 2-10 mcg/min (bradycardia)
0.1-0.5 mcg/kg/min (ROSC) - Answer-Epi
Indications: angina
Dose: 0.3-0.6 mg SL q 5 minutes (max 3 doses w/in 15 min) - Answer-Nitro
Indications: V-tach (monomorphic: stable, wide QRS tachycardia)
Dose:
20-50 mg/min until arrhythmia subsides, hypotension occurs, QRS increased by 50%,
or maximum dose of 17 mg/kg
Maintenance infusion: 1-4 mg/min - Answer-Procainimide (Anti-arrythmic)
FOLLOW IV MEDS WITH A ___CC SALINE FLUSH AND ELEVATE EXTREMITY TO
FACILITATE CIRCULATION OF MEDICATION - Answer-20
Centrally inserted catheter, or central venous catheters (CVC) rests in the distal end of
the ____ near the junction with the ___ - Answer-superior vena cava, right atrium
60-100 bpm (normal pacemaker) - Answer-SA node
40-60 bpm - Answer-AV node
20-40 bpm - Answer-Purkinje fibers
indications for _________
Severe Bradycardia with hemodynamic instability- Not responsive to Atropine
Symptomatic Bradycardia
High degree of Heart Block
Sinus Arrest - Answer-cardiac pacing
Pacing the atrium because it is right before p wave which represents atrium
20% of cardiac output in generated in atrium - Answer-Single chamber pacing
Causes:
Loose hookups
Dead battery
Malfunctioning pulse generator - Answer-Failure to fire
Clues: renal failure
Treatment: Sodium Bicarbonate, hyperventilate - Answer-Hydrogen ion (acidosis)
Clues: neck vein distention, tracheal deviation, unequal breath sounds, difficulty
ventilating patient
