Cardiac Life Support Practice Questions Module 1

Cardiac Life Support Practice Questions Module 1 define cardiac arrest - CORRECT ANSWER-the cessation of cardiac mechanical activity as confirmed by the absence of signs of circulation describe the 4 steps of BLS - CORRECT ANSWER-1. check responsiveness 2. activate Emergency response and get AED 3. circulation ( pulseless--- CPR) 4. defibrillation (if no pulse, check for shockable rhythym) T or F pulse oximetry is usually not reliable due to inadequate BF in peripheral tissue beds during ACLS - CORRECT ANSWER-T whats the normal PetCO2 ( end-tidal CO2) - CORRECT ANSWER-35-40 mm Hg the PetCO2 will approach _____ during untreated cardiac arrest - CORRECT ANSWER-approaches 0 because there is no gas exchange how is a PetCO2 value useful during CPR? - CORRECT ANSWER-used to assess CO because as CO increases through effective CPR it yields higher PetCO2 as delivery of CO2 to the lungs increases ROSC - CORRECT ANSWER-return of spontaneous circulation persistently low PetCO2 values (10 mm Hg ) during CPR in intubated patients suggests that ______ is unlikely - CORRECT ANSWER-ROSC... bad prognosis meanwhile... abrupt sustained increases in PetCO2 to normal values during CPR is an indicator of ROSC what are S/S of hypoxia - CORRECT ANSWER-cyanosis blood gases airway problems what visual way can you confirm hypovolemia? - CORRECT ANSWER-flat neck veins how do you treat hydrogen ion acidosis? - CORRECT ANSWER-sodium bicarb hyperventilation T or Fvasopressors are not useful in improving survival in ACLS - CORRECT ANSWER-T - some evidence that they may improve ROSC and short-term survival what is the first-line medication for the treatment of cardiac arrest - CORRECT ANSWER-epinephrine MOA epinephrine - CORRECT ANSWER-stimulates alpha and beta receptors - vasoconstriction -increased BP -increase HR -improve perfusion pressure to brain and heart -efficacy thought to be thru alpha receptors T or F Beta effects of epinephrine may be harmful in cariac arrest - CORRECT ANSWER-T because it increases myocardial oxygen demand ( heart pump harder and faster) T or F there is no survival benefit of high dose vs low dose epi - CORRECT ANSWER-T rational behind vasopressin use in cardiac arrest - CORRECT ANSWER-none.... no advantage as a substitute or in combination with epinephrine selective alpha 1 vasopressor? - CORRECT ANSWER-phenylephrine is phenylephrine useful as a vasopressor? - CORRECT ANSWER-not really.. its only alpha 1 so lacking alpha 2 receptor effects so no long-term survival advantage over epinephrine which receptors does NE hit? - CORRECT ANSWER-alpha 1,2 beta 1 how does NE differ from epi in terms of ROSC, hostpital admissions, or hospital discharge? - CORRECT ANSWER-the same what is the purpose of using AAD in cardiac arrest? - CORRECT ANSWER-prevent the development of recurrence of VF and PVT by raising the fibrillation threshold There is _____ evidence that AAD increase survival to hospital discharge during cardiac arrest a. lots of b. no - CORRECT ANSWER-nowhat AAD are used in cardiac arrest? - CORRECT ANSWER-amiodarone lidocaine Mg sulfate when is amiodarone indicated? - CORRECT ANSWER-used in VF or PVT nresponsive to shock deliver, CPR and a vasopressor what is considered when amiodarone is not available? - CORRECT ANSWER-lidocaine ( no short term or long term efficacy in cardiac arrest) purpose of MG sulfate? - CORRECT ANSWER-to terminate or prevent recurrent TdP in patients who have prolonged QT interval during normal sinus rhythm - routine use of Mg sulfate in cardiac arrest is not recommended T or F atropine is still used in the cardiac arrest algorithm but is at the end - CORRECT ANSWER-F no longer included ( insufficient evidence to support or refute its use) why is sodium bicarb not recommended in routine cardiac arrest except in certain cases? - CORRECT ANSWER-it may worsen pCO2 - few clinical data supporting its use what circumstances would you consider sodium bicarb therapy in cardiac arrest? - CORRECT ANSWER-underlying metabolic acidosis hyperkalemia TCA overdose use _______ in patients with respiratory arrest with known or suspected opioid addiction - CORRECT ANSWER-naloxone... administer after beginning CPR if you find out they are an addict steroid use in cardiac arrest is controversial but, a study showed a survival beneift when???? - CORRECT ANSWER-when used in a bundle of methylprednisolone, vasopressin, epi, followed by hydrocortisone - but unable to determine which item in the bundle caused the benefit - not really recommended right now...need more studies time to peak drug concentration when delivering via peripheral IV access can be attained by using what administration technique? - CORRECT ANSWER-if you follow the drug dose with a 20ml fluid bolus (to push contents of drug through)