FULL QUESTIONS AND ANSWERS ALREADY
PASSED
◍ V2 . Answer: 4th intercostal space, L sternal border.
◍ V4 . Answer: 5th intercostal space, left midclavicular line
◍ V3 . Answer: Midway between V2 and V4. Use for normal rhythms
with no arrhythmias
◍ preload . Answer: the stretch before a contraction, when the ventricle
fills. how wet or dry the pt is
◍ low preload . Answer: pt is dry, give fluids
◍ high preload . Answer: pt is wet, give lasix, vasodilators, dialysis
◍ contractility . Answer: how much squeeze the heart has
,◍ low afterload . Answer: dilated arteries. caused by sepsis, shock.
transfer pt to ICU for vasoconstrictors
◍ high afterload . Answer: constricted arteries. can be caused by
hypothermia, hypovolemia, cardiogenic shock. treat the cause
◍ afterload . Answer: the resistance the ventricle muscle has to go up
against to pump out the blood. how clamped down or dilated the pt is
◍ low contractility . Answer: give positive inotropes
◍ positive inotropes . Answer: digoxin, dobutamine, dopamine,
milrinone
◍ stable angina . Answer: chest pain that occurs when a person is active
or under severe stress. caused by imbalance of O2 delivery and demand
◍ unstable angina . Answer: chest pain that occurs while a person is at
rest and not exerting himself. caused by plaque rupture and thrombus
formation
◍ NSTEMI . Answer: ST depression or T wave inversion, cardiac
ischemia. thrombus is intermittently occlusive, causes non full thickness
infarction of myocardium
, ◍ STEMI . Answer: ST elevation MI, real-time ongoing death of heart
tissue due to cardiac injury. thrombus is occlusive and causes full
thickness infarction
◍ ACS . Answer: unstable angina w/ normal troponin, NSTEMI w/
elevated troponin, STEMI with elevated troponin
◍ MI treatment . Answer: Notify physician, obtain 12 lead ECG within
10 minutes.
Morphine - pain relief, decreases workload of heart
Oxygen if sats <92% - improve oxygenation
Nitroglycerin - increase perfusion to heart
Aspirin - stops platelets from forming
Heparin - prevents formation of fibrin
Beta blocker - slows heart, decreases O2 demand of heart
Transfer to cath lab
◍ how to measure ST elevation . Answer: 0.06 seconds (box and a half)
after J point, count boxes vertically up from isoelectric line