Complete Questions And Correct Answers With
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Reading an ECG Strip - ---answer---;- Each small box is 0.04 seconds
- Each large box is 0.20 seconds
- 30 large boxes = 6 seconds
Cardiac Pacing - ---answer---;- Indications: failure of heart to initiate or conduct electrical impulse at an
adequate pace; can be for tachy or bradydysrhythmias
-Conditions: sick sinus syndrome, afib with sinus node dysfunction, complete atrioventricular block
(third-degree), asystole, prolonged QT syndrome
-How it works: senses patient's rhythm and sends electrical signals to maintain rate
How to Identify Pacemaker function - ---answer---;- Identified with 3 letters which indicate cardiac
chambers paced, sensed, and mode of pacing
-First letter (A, V, or D): refers to the chambers paced; Atria, Ventricles, or Dual aka both chambers
- Second letter ( A, V, or D): refers to the chamber sensed; Atria, Ventricles, or Dual
,-Third letter (I, T, or D): refers to mode of pacing; Inhibited, Triggered, or Dual
Oropharyngeal Airway - ---answer---;-a curved device inserted through the patient's mouth into the
pharynx to help maintain an open airway; be careful of dentures
-Color coded according to side
-Put it in sideways, then have curve face down
-If patient is unconscious, tilt head and thrust jaw; never intubate conscious patient due to gag reflex
-Always do a chest x ray after intubation, monitor airway patency, listen to breath sounds
Endotracheal Tube - ---answer---;-a catheter inserted into the trachea to provide or protect an airway
-use a laryngoscope to guide the tube to appropriate place
-cuff inflated at end of the tube to keep it in place and create a seal to prevent air from getting out
Process of intubation - ---answer---;- push paralytics and ketamine/rocuronium prior to intubation
-Be careful to push ketamine first then paralytics because if you paralyze before sedating, breathing will
also be weakened
-Ventilate with 100% oxygen; cannot extubate without proper checks and balances
-tubes cannot stay long due to fear infection; if long-term issue, we trach and peg them
-breath sounds on one side means you went down too far (importance of diagnostics like chest x rays)
, Tracheostomy - ---answer---;-Dry secretions are worse than moist secretions
-Clean site every 8-12 hours
-Cannula is disposable
-Obturator is something you can use to stick in if the trach falls out. You do not want to put a trach back
in after losing the airway
Mechanical Ventilation - ---answer---;- Indication: patient cannot breathe on their own; change in
mental status or loss of airway
-Causes: narcotic overdose; respiratory acidosis
-Purpose: maximize oxygen transport, correct hypoxemia, correct respiratory acidosis, maintain alveolar
ventilation
-PEEP: keeps alveoli open; standard pressure is 5
-Use lowest FiO2 (40%) to prevent lung injury
-Mechanical ventilation is needed when a patient cannot maintain adequate O2
-Interventions: Keep HOB at least 30 degrees; give some breathing assistance after extubating and
monitor closely
Lung Injury with Positive Pressure Ventilation - ---answer---;-Barotrauma
-Volutrauma