NURS 480: Week 2, Test 1 Study Guide

NURS 480: Week 2, Test 1 Study Guide 1. Characteristics of V- Fib and Vtach VFIB • no pulse • not breathing • HR is not measurable • Rhythm is irregular and chaotic • The P wave is not visible and the P-R interval and the QRS interval are not measurable VTach • Rate: 150-250 beats/minute • can have a pulse or may not o FIRST THING TO DO: CHECK FOR A PULSE o if no pulse get the defib right away (PICK DEFIB RATHER THAN CPR) • Rhythm may be regular or irregular • AV dissociation may be present, with P waves occurring independently of the QRS complex • The atria may be depolarized by the ventricles in a retrograde fashion • The P wave is usually buried in the QRS complex, and the P-R interval is not measurable • The QRS complex is distorted in appearance and wide (greater than 0.12 seconds in duration) 1. Strip has no visible P wave the PR interval is not measurable your ventricular rate is 162 the R to R intervals are regular your QRS complex are distorted and why is your QRS duration 0.18 seconds? How would you interpret this rhythm? a. Ventricular Tachycardia 2. Nursing action if a patient has VTach or VFIB and no pulse and apenic, what are you going to do? a. FIRST THING TO DO: CHECK FOR A PULSE ■ if no pulse, get the defibrillator right away (PICK DEFIB RATHER THAN CPR in the quiz) 3. Strip has sinus tachycardia but the patient has no pulse and is not breathing. What are you going to do, what is your next action? a. CPR 4. Depending on where the MI is occurring you can see it on the leads, LEADS: 2,3, and AVF helps reflect inferior area of the heart (that would be a Inferior MI) 5. Lead 2 is the best lead to capture ECG changes to damage to the Myocardium 6. Know which leads to assess for MI a. ST elevation in the ECG leads facing the area of infarction b. Anterior leads V3 and V4, and J point 7. If you're providing patient teaching about cardiac enzymes what would be your teaching regarding the purpose? Why are we drawing? a. We check cardiac enzymes Troponin T and I because this test shows the degree of the damage to the heart/to determine the degree of the damage of heart tissues.If you have come to the emergency department with chest pain, cardiac enzymes may be drawn two or three times, several hours apart. It can also be used to check the functioning of the heart after coronary artery bypass graft surgery or angioplasty. 8. If your Patient is asking you why the doctor wants them to go to cardiac rehab when the cardiac damage has cannot be reversed or nothing can be done with the damage, what would be your most appropriate response? a. Cardiac rehabilitation is the restoration of a person to an optimal state of function in six areas: physiological, psychological, mental, spiritual, economic, and vocational