BKAT ICU UPDATED EXAMS SCRIPT QUESTIONS AND
ANSWERS SURE A+
✔✔If chronically using cortisone be sure to _____ to prevent _____. - ✔✔If chronically
using cortisone be sure to taper the medications to prevent acute adrenal insufficiency
✔✔This medication is a cardiac glycoside that increases contractility. - ✔✔Digoxin
✔✔Digoxin increases contractility by - ✔✔slowing the heart rate which decreases
conduction through the AV node
✔✔What should be monitored in patients taking Digoxin? - ✔✔hypotension,
bradycardia, and symptoms of toxicity
✔✔Signs/Symptoms of Digoxin toxicity - ✔✔nausea, yellow vision/halo, paroxysmal
atrial tachycardia (PAT with block).
✔✔True/Flase:
Digoxin WILL NOT cause rapid AV conduction or hypertension - ✔✔True
✔✔what medication is a antiarrhythmic that suppresses automaticity and
depolarization? - ✔✔lidocaine
✔✔Lidocaine is used to treat? - ✔✔ventricular dysrhythmias
✔✔lidocaine toxicity sign - ✔✔mental confusion/change in LOC
✔✔Monitor serum levels with _________ - ✔✔Lidocaine
✔✔DO NOT give _______ medications to patients with suppressed respirations -
✔✔Narcotics (morphine, dilaudid)
✔✔What changes on a EKG would you expect to see on a patient with a acute MI? -
✔✔ST elevation
✔✔normal QRS:
Prolonged QRS indicates: - ✔✔<0.12 seconds is normal QRS
prolonged QRS indicates intraventricular conduction defect, typically a bundle branch
block
✔✔Distinguishing V-fib - ✔✔fibrillatory waves with no recognizable pattern
Defib the Vfib
, ✔✔Distinguishing V-Tach - ✔✔atrial rhythm and rate cannot be identified
"Tombstones"
✔✔First degree block interpretation - ✔✔looks like sinus rhythm but the PR is longer
than normal. there will be 1 p for every qrs, but the PR interval will be greater than 0.20
sec
✔✔Type 1 second degree block interpretation - ✔✔"Wenckebach"
"Longer, Longer... drop" prolonged PR intervals and the missing QRS
✔✔Type 2 second degree block interpretation - ✔✔PR interval is constant...QRS is
missing
"2 small p waves right after each other"
give atropine, dopamine, or epi to increase HR is symptomatic bradycardic
✔✔Third degree AV block interpretation - ✔✔a strip of p-waves laid independently over
a strip of QRS complexes. Note that the p wave doesn't conduct the QRS complex that
follows it.
✔✔A-flutter interpretation - ✔✔abnormal p-waves that produce a saw-tooth appearance
✔✔Failure to Capture interpreation - ✔✔spike without a complex
✔✔Failure to Pace interpretation - ✔✔no pacemaker activity or spike at the set rate on
an ECG. usually caused by battery or circuit failure, cracked or broken pacing leads,
loose connections, oversensing, or the pacing output is too low--->can lead to asystole
✔✔Failure to Sense - ✔✔undersensing: giving help when not needed; spikes occur on
the ECG where they shouldnt
✔✔Pacemaker ECG rhythms - ✔✔failure to capture: spike without a p wave or QRS
complex following it
failure to pace: no spike on ECG at the rate set
failure to sense:
spike when intrinsic activity already present (undersensing)
no spike when patient needs it
(oversensing)
✔✔Which ventricular stimulus is dangerous - ✔✔R on T phenomenon
✔✔Indications for a pacemaker? - ✔✔symptomatic bradycardia
higher AV blocks (2nd degree type 2 or Complete)
✔✔what is not a treatment for higher degree AV blocks - ✔✔atropine
ANSWERS SURE A+
✔✔If chronically using cortisone be sure to _____ to prevent _____. - ✔✔If chronically
using cortisone be sure to taper the medications to prevent acute adrenal insufficiency
✔✔This medication is a cardiac glycoside that increases contractility. - ✔✔Digoxin
✔✔Digoxin increases contractility by - ✔✔slowing the heart rate which decreases
conduction through the AV node
✔✔What should be monitored in patients taking Digoxin? - ✔✔hypotension,
bradycardia, and symptoms of toxicity
✔✔Signs/Symptoms of Digoxin toxicity - ✔✔nausea, yellow vision/halo, paroxysmal
atrial tachycardia (PAT with block).
✔✔True/Flase:
Digoxin WILL NOT cause rapid AV conduction or hypertension - ✔✔True
✔✔what medication is a antiarrhythmic that suppresses automaticity and
depolarization? - ✔✔lidocaine
✔✔Lidocaine is used to treat? - ✔✔ventricular dysrhythmias
✔✔lidocaine toxicity sign - ✔✔mental confusion/change in LOC
✔✔Monitor serum levels with _________ - ✔✔Lidocaine
✔✔DO NOT give _______ medications to patients with suppressed respirations -
✔✔Narcotics (morphine, dilaudid)
✔✔What changes on a EKG would you expect to see on a patient with a acute MI? -
✔✔ST elevation
✔✔normal QRS:
Prolonged QRS indicates: - ✔✔<0.12 seconds is normal QRS
prolonged QRS indicates intraventricular conduction defect, typically a bundle branch
block
✔✔Distinguishing V-fib - ✔✔fibrillatory waves with no recognizable pattern
Defib the Vfib
, ✔✔Distinguishing V-Tach - ✔✔atrial rhythm and rate cannot be identified
"Tombstones"
✔✔First degree block interpretation - ✔✔looks like sinus rhythm but the PR is longer
than normal. there will be 1 p for every qrs, but the PR interval will be greater than 0.20
sec
✔✔Type 1 second degree block interpretation - ✔✔"Wenckebach"
"Longer, Longer... drop" prolonged PR intervals and the missing QRS
✔✔Type 2 second degree block interpretation - ✔✔PR interval is constant...QRS is
missing
"2 small p waves right after each other"
give atropine, dopamine, or epi to increase HR is symptomatic bradycardic
✔✔Third degree AV block interpretation - ✔✔a strip of p-waves laid independently over
a strip of QRS complexes. Note that the p wave doesn't conduct the QRS complex that
follows it.
✔✔A-flutter interpretation - ✔✔abnormal p-waves that produce a saw-tooth appearance
✔✔Failure to Capture interpreation - ✔✔spike without a complex
✔✔Failure to Pace interpretation - ✔✔no pacemaker activity or spike at the set rate on
an ECG. usually caused by battery or circuit failure, cracked or broken pacing leads,
loose connections, oversensing, or the pacing output is too low--->can lead to asystole
✔✔Failure to Sense - ✔✔undersensing: giving help when not needed; spikes occur on
the ECG where they shouldnt
✔✔Pacemaker ECG rhythms - ✔✔failure to capture: spike without a p wave or QRS
complex following it
failure to pace: no spike on ECG at the rate set
failure to sense:
spike when intrinsic activity already present (undersensing)
no spike when patient needs it
(oversensing)
✔✔Which ventricular stimulus is dangerous - ✔✔R on T phenomenon
✔✔Indications for a pacemaker? - ✔✔symptomatic bradycardia
higher AV blocks (2nd degree type 2 or Complete)
✔✔what is not a treatment for higher degree AV blocks - ✔✔atropine
