BKAT 9r Exam 2023/2024 with complete solutions

BKAT 9r Exam 2023/2024 Adenosine, when is it used? - Answer- Paroxysmal supraventricular tachycardia Adenosine, what is the effect - Answer- slows the heart adenosine what is the dosage given - Answer- 6mg IV push rapidly followed by 20mls of NS. Adenosine what if the patient does not respond to the 6mg - Answer- if no response in 1-2 min give 12 mg and flush. may repeat. Amiodarone what is the effect - Answer- slowing the heart Amiodarone, when is it used - Answer- V-fib, v tach, atrial tachyarrhythmia's amiodarone what is the dosage given - Answer- 150 mg over 10 min if a pulse. no pulse give 300 mg rapidly and then 150 mg rapid for the next dose. atropine, what does it do - Answer- speeds up the heart; increased conduction through the AV node Atropine, when is it used - Answer- 1st drug given for bradycardia. can be given through the ETT atropine, what is the dose given - Answer- dosing 0.5 mg IV every 5 min. max is 3mg Warning: a dose <0.5 will actually cause the heart to slow. dopamine, what is the effect - Answer- speeds the heart up and contractility increases. it helps manage hypotension when there is no hypovolemia involved dopamine when is it used - Answer- 2nd line drug for symptomatic bradycardia. dopamine what is the dosage - Answer- 2-10 mcg for vasoconstriction 10-20 mcg for contractility effect for bradycardia give 2-10. we titrate until the we get the proper effect of the drug. epinephrine, what does it do - Answer- increase heart rate and blood pressure epinephrine when is it used - Answer- cardiac arrest, symptomatic bradycardia, severe hypotension, and anaphylaxis epinephrine what is the dose - Answer- cardiac arrest 1 mg (10ml of 1:10,000 solution) premix every 3 minutes bradycardia 2-10 mcg/min titrate to effect for hypotension (remember to tank them up first) no dose on the study guide. magnesium sulfate, when is it used - Answer- used for cardiac arrest only if torsade's de pointes or hypomagnesium is suspected magnesium sulfate, what is the dose - Answer- 1-2 grams (2-4 ml of 50% solution) diluted in 10 ml of D5W IV (no time given) vasopressin what is the effect - Answer- increased blood pressure vasopressin what is the dose - Answer- 40 units IV for V fib and pulseless V tach. can be placed in the ETT. can take the place of epinephrine for either the 1st or 2nd dose or may not be used at all. Mr Adams, a 68 yo patient, complains of feeling "a little funny in his chest". His EKG shows atrial fibrillation/flutter. Which of the following medications could be used to treat his cardiac rhythm? - Answer- 1)Levophed 2)nifedipine 3)Cardizem * 4)adenosine A patient becomes apneic and pulseless. The monitor shows asystole. The drug that would most likely be used initially is - Answer- 1)amiodarone 2)atropine 3)epinephrine * 4)lidocaine When feeding a patient using continuous tube feedings, the most important intervention in preventing aspiration is to: - Answer- 1) keep the head of the bed elevated * 2) aspirate stomach contents q4h for residual 3) check the position of the feeding tube each shift 4) turn the patient frequently Upon recognizing ventricular fibrillation in a safe environment, the nurse should then - Answer- 1)perform a precordial thump 2)establish unresponsiveness * 3)give amiodarone IV 4)check the ECG leads The most important step in preventing central venous catheter related sepsis is: - Answer- 1)use of a transparent membrane dressing 2)changing the catheter weekly 3)using antibiotic ointment under the dressing 4)thorough handwashing * A routine check of your patient's blood gas values show a pH of 7.40, pO2 of 98 mm Hg, pCO2 of 38 mm Hg, and HCO3 of 25 mEq. These results reflect: - Answer- 1)metabolic acidosis 2)metabolic alkalosis 3)normal values * 4)respiratory compensation The major goal in the treatment of cardiogenic shock is to: - Answer- 1)increase the afterload 2)lower the BUN 3)increase cardiac output * 4)decrease fluid volume The earliest sign of increased intracranial pressure generally involves changes in: - Answer- 1)response to pain 2)level of consciousness * 3)equality of pupillary reaction 4)respiratory rate Precordial Landmarks A, P, E, T, M - Answer- Aortic- 2nd intercostal space at the right sternal border Pulmonic- 2nd intercostal space at the left sternal border Erbs point- 3rd intercostal space and the left sternal border. Tricuspid- 4th intercostal space at the left sternal border Mitral-5th intercostal space at the midclavicular line stroke volume - Answer- volume of blood pumped from the left ventricle per beat. CO = HR x SV (CO/HR = SV) ml = 70 x 70ml Preload Contractility Afterload - Answer- Preload- end diastolic volume that stretches the right or left ventricle of the heart Contractility- How hard the heart pumps (Systole) Afterload- pressure against which the heart must work to eject blood during systole