FCCN LEVEL 1 STUDY GUIDE UPDATED EXAM QUESTIONS
AND SOLUTIONS RATED A+
✔✔ACS - ✔✔unstable angina w/ normal troponin, NSTEMI w/ elevated troponin, STEMI
with elevated troponin
✔✔MI treatment - ✔✔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 - ✔✔0.06 seconds (box and a half) after J point, count
boxes vertically up from isoelectric line
✔✔J point - ✔✔Point where the QRS complex and ST segment meet
✔✔QT interval - ✔✔ventricular depolarization and repolarization, beginning of QRS to
end of T wave
✔✔QTc - ✔✔QT corrected for heart rate, prolonged >500
✔✔sodium - ✔✔135-145
✔✔hyponatremia causes and S/S - ✔✔causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
✔✔hypernatremia causes and S/S - ✔✔causes: water deficit or excessive sodium
intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
✔✔potassium - ✔✔3.5-5.0
✔✔hypokalemia causes and S/S - ✔✔causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
✔✔hyperkalemia causes and S/S - ✔✔causes: medications, renal failure, high intake,
acidosis
, s/s: tall peaked T waves, muscle weakness, AV blocks
✔✔calcium - ✔✔8.5-10.5
✔✔hypocalcemia causes and S/S - ✔✔causes: excessive loss from diarrhea,
malabsorption syndromes
s/s: positive Chvostek's (facial spasm), positive Trousseau's (carpal spasm), prolonged
QT interval, seizures, decreased cardiac contractility
✔✔hypercalcemia causes and S/S - ✔✔causes: hyperparathyroidism, high intake
s/s: muscle weakness, confusion, dysrhythmias, abd pain
✔✔magnesium - ✔✔1.7-2.2
✔✔hypomagnesemia causes and S/S - ✔✔causes: high GI output, alcoholism, DKA,
pancreatitis
s/s: tetany, weakness, widened QRS, prolonged PR
✔✔hypermagnesemia causes and S/S - ✔✔causes: renal failure, high intake
s/s: vasodilation, hypotension. above 15 - respiratory failure, asystole, coma
✔✔phos - ✔✔2.5-4.5
✔✔hypophosphatemia causes and S/S - ✔✔causes: increased excretion,
hyperparathyroidism
s/s: confusion, poor tissue oxygenation, high calcium levels
✔✔hyperphosphatemia causes and S/S - ✔✔causes: high intake, kidney disease,
sepsis
s/s: stroke, arteriosclerosis, poor circulation, itching
✔✔order of lyte replacement - ✔✔mag
potassium
phos
calcium
✔✔isotonic fluid - ✔✔has tonicity that is equal to the plasma in the body. causes no fluid
shift into/out of cells. Given for dehydration
LR, NS
✔✔hypotonic fluid- types - ✔✔has lower tonicity than plasma in the body. causes fluids
to shift into the cell, and cells swell
D5W, 0.45 NS
AND SOLUTIONS RATED A+
✔✔ACS - ✔✔unstable angina w/ normal troponin, NSTEMI w/ elevated troponin, STEMI
with elevated troponin
✔✔MI treatment - ✔✔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 - ✔✔0.06 seconds (box and a half) after J point, count
boxes vertically up from isoelectric line
✔✔J point - ✔✔Point where the QRS complex and ST segment meet
✔✔QT interval - ✔✔ventricular depolarization and repolarization, beginning of QRS to
end of T wave
✔✔QTc - ✔✔QT corrected for heart rate, prolonged >500
✔✔sodium - ✔✔135-145
✔✔hyponatremia causes and S/S - ✔✔causes: dilutional or depletional
s/s: n/v, abd cramping, lethargy, weakness, headache, seizures, coma
✔✔hypernatremia causes and S/S - ✔✔causes: water deficit or excessive sodium
intake
s/s: thirst, increased temp, dry/sticky mucous membranes, restlessness, disorientation,
convulsions
✔✔potassium - ✔✔3.5-5.0
✔✔hypokalemia causes and S/S - ✔✔causes: GI losses, diuretics, poor intake
s/s: flattened T waves, U wave (late sign)
✔✔hyperkalemia causes and S/S - ✔✔causes: medications, renal failure, high intake,
acidosis
, s/s: tall peaked T waves, muscle weakness, AV blocks
✔✔calcium - ✔✔8.5-10.5
✔✔hypocalcemia causes and S/S - ✔✔causes: excessive loss from diarrhea,
malabsorption syndromes
s/s: positive Chvostek's (facial spasm), positive Trousseau's (carpal spasm), prolonged
QT interval, seizures, decreased cardiac contractility
✔✔hypercalcemia causes and S/S - ✔✔causes: hyperparathyroidism, high intake
s/s: muscle weakness, confusion, dysrhythmias, abd pain
✔✔magnesium - ✔✔1.7-2.2
✔✔hypomagnesemia causes and S/S - ✔✔causes: high GI output, alcoholism, DKA,
pancreatitis
s/s: tetany, weakness, widened QRS, prolonged PR
✔✔hypermagnesemia causes and S/S - ✔✔causes: renal failure, high intake
s/s: vasodilation, hypotension. above 15 - respiratory failure, asystole, coma
✔✔phos - ✔✔2.5-4.5
✔✔hypophosphatemia causes and S/S - ✔✔causes: increased excretion,
hyperparathyroidism
s/s: confusion, poor tissue oxygenation, high calcium levels
✔✔hyperphosphatemia causes and S/S - ✔✔causes: high intake, kidney disease,
sepsis
s/s: stroke, arteriosclerosis, poor circulation, itching
✔✔order of lyte replacement - ✔✔mag
potassium
phos
calcium
✔✔isotonic fluid - ✔✔has tonicity that is equal to the plasma in the body. causes no fluid
shift into/out of cells. Given for dehydration
LR, NS
✔✔hypotonic fluid- types - ✔✔has lower tonicity than plasma in the body. causes fluids
to shift into the cell, and cells swell
D5W, 0.45 NS
