Nur 245 Exam 1 Questions with Answers
Sinus Bradycardia - correct answers-SA node fires at a rate less than 60
- symptomatic: fatigue, dizziness, chest pain, syncope, pale/cool skin, hypotension, weakness, confusion,
disorientation, SOB
drugs* BB, CCB
*may be normal in athletes and some people during sleep
Sinus Bradycardia Treatment - correct answers-treat patient with symptoms
- give O2
*IV atropine
if atropine is ineffective, PACING, or dopamine/epinephrine (adrenalin) infusion is considered
if d/t drugs, may have to hold, d/c, and decrease
Sinus Tachycardia - correct answers-*dizziness, dyspnea, hypotension bc of - decreased CO = increased
myocardial O2 consumption
CAD = angina
discharge rate from the SA node increased bc of vagal inhibition or sympathetic stimulation
rate 101-200
can be caused from fever, pain, hypotension, hypovalemia, anemia, hypoxia, hypoglycemia, MI, HF,
hypothyroidism, anxiety, fear
- drugs; EPI, NOR-EPI, atropine, caffeine, theophylline, hydralazine
OTC - Sudafed
Sinus Tachycardia Treatment - correct answers-*treat underlying cause
stable pt = vagal maneuver, BB, adenosine, CCB - to decrease HR
unstable pt = cardioversion
Atrial Flutter - correct answers-recurring, regular, narrow, sawtoothed shaped flutter
*CAD, HTN
rate = 200-350
PR variable no measureable
QRS normal
*Increase risk of stroke = give Coumadin
Atrial Flutter Treatment - correct answers-goal* slow ventricular rate response by increasing AV block
,control ventricular rate with BB, CCB
- electronical cardioversion may be done to convert to NSR in an emergency
*antidysrhythmics = amiodarone, flecainide, dronedarone
Atrial Fibrillation (A-Fib) - correct answers-total disorganization of atrial electricity
rate 350-600
no P waves, IRREGULAR rhythm
- decreased CO, thrombi form in atria = STROKE
Atrial Fibrillation (A-Fib) Treatment - correct answers-goal* decrease ventricular response to less than
100, prevention of stroke, conversion to SR if possible.
drugs for ventricular rate control* CCD, BB, dronedarone, and digoxin
Digoxin (decreased heart rate) - correct answers-*used for patients with AFIB
1.5-2.5
- hypokalemia = major cause of toxicity
monitor for hypo or hyperkalemia
EARLY = anorexia, N/V, fatigue, HA, depression, visual changes
LATE = dysrhythmias, bradycardia, AV block
PVC - correct answers-premature ventricular contraction
early occurance of a QRS
- wide and distorted in shape
VT occurs when there are 3 or more consecutives PVC's
*caffeine, alcohol, aminophylline, EPI, digoxin, isoproterenol, electrolyte imbalance, hypoxia, fever,
exercise, stress
PVC Treatment - correct answers-check O2 = can be r/t hypoxia
check K+= electrolyte imbalance
- assess hemodynamic status
drugs*BB, procainamide, or amiodarone
Ventricular Tachycardia - correct answers-a run of 3 or more PVC/s
*life threatening, decrease CO, and possible development of V-FIB
rate 50-200
, WIDE, bizarre QRS (>0.12)
*electrolyte imbalance, ischemia
Ventricular Tachycardia Treatment - correct answers-asses pulse
No pulse = life threatening
*CPR and rapid defibrillation
followed by EPI and Amiodarone if defibrillation is unsuccessful
Ventricular fibrillation (V-fib) - correct answers-IRREGULAR waveforms of varying shapes
- acute MI and HR
*HR not measurable, rhythm irregular and chaotic
NO P wave, QRS not measurable
Ventricular fibrillation (V-fib) Treatment - correct answers-*CPR, ACLS, Defibrillation
*EPI
Asystole - correct answers-CPR, ACLS, EPI
CVP - correct answers-how much volume is in the right atrium
- right side
- measure with patient at a 45 degree angle and straight edge on JVD with 2 rulers
INCREASED = needs volume
DECREASED = fluid overload (fluid restriction)
Cardiac Output - correct answers-heart rate x stroke volume
amount of blood the heart pumps in a minute
(4-6L)
Ejection Fraction - correct answers-*55-75%
amount of blood the left ventricle pumps out
Stroke Volume - correct answers-The volume of blood pumped from a ventricle of the heart in one beat
Preload - correct answers-amount of blood returning
- causes stretch
*Sterlings Law
Afterload - correct answers-resistance the heart pumps against
Pulmonary Artery Pressure (PAP) - correct answers-*left side
Sinus Bradycardia - correct answers-SA node fires at a rate less than 60
- symptomatic: fatigue, dizziness, chest pain, syncope, pale/cool skin, hypotension, weakness, confusion,
disorientation, SOB
drugs* BB, CCB
*may be normal in athletes and some people during sleep
Sinus Bradycardia Treatment - correct answers-treat patient with symptoms
- give O2
*IV atropine
if atropine is ineffective, PACING, or dopamine/epinephrine (adrenalin) infusion is considered
if d/t drugs, may have to hold, d/c, and decrease
Sinus Tachycardia - correct answers-*dizziness, dyspnea, hypotension bc of - decreased CO = increased
myocardial O2 consumption
CAD = angina
discharge rate from the SA node increased bc of vagal inhibition or sympathetic stimulation
rate 101-200
can be caused from fever, pain, hypotension, hypovalemia, anemia, hypoxia, hypoglycemia, MI, HF,
hypothyroidism, anxiety, fear
- drugs; EPI, NOR-EPI, atropine, caffeine, theophylline, hydralazine
OTC - Sudafed
Sinus Tachycardia Treatment - correct answers-*treat underlying cause
stable pt = vagal maneuver, BB, adenosine, CCB - to decrease HR
unstable pt = cardioversion
Atrial Flutter - correct answers-recurring, regular, narrow, sawtoothed shaped flutter
*CAD, HTN
rate = 200-350
PR variable no measureable
QRS normal
*Increase risk of stroke = give Coumadin
Atrial Flutter Treatment - correct answers-goal* slow ventricular rate response by increasing AV block
,control ventricular rate with BB, CCB
- electronical cardioversion may be done to convert to NSR in an emergency
*antidysrhythmics = amiodarone, flecainide, dronedarone
Atrial Fibrillation (A-Fib) - correct answers-total disorganization of atrial electricity
rate 350-600
no P waves, IRREGULAR rhythm
- decreased CO, thrombi form in atria = STROKE
Atrial Fibrillation (A-Fib) Treatment - correct answers-goal* decrease ventricular response to less than
100, prevention of stroke, conversion to SR if possible.
drugs for ventricular rate control* CCD, BB, dronedarone, and digoxin
Digoxin (decreased heart rate) - correct answers-*used for patients with AFIB
1.5-2.5
- hypokalemia = major cause of toxicity
monitor for hypo or hyperkalemia
EARLY = anorexia, N/V, fatigue, HA, depression, visual changes
LATE = dysrhythmias, bradycardia, AV block
PVC - correct answers-premature ventricular contraction
early occurance of a QRS
- wide and distorted in shape
VT occurs when there are 3 or more consecutives PVC's
*caffeine, alcohol, aminophylline, EPI, digoxin, isoproterenol, electrolyte imbalance, hypoxia, fever,
exercise, stress
PVC Treatment - correct answers-check O2 = can be r/t hypoxia
check K+= electrolyte imbalance
- assess hemodynamic status
drugs*BB, procainamide, or amiodarone
Ventricular Tachycardia - correct answers-a run of 3 or more PVC/s
*life threatening, decrease CO, and possible development of V-FIB
rate 50-200
, WIDE, bizarre QRS (>0.12)
*electrolyte imbalance, ischemia
Ventricular Tachycardia Treatment - correct answers-asses pulse
No pulse = life threatening
*CPR and rapid defibrillation
followed by EPI and Amiodarone if defibrillation is unsuccessful
Ventricular fibrillation (V-fib) - correct answers-IRREGULAR waveforms of varying shapes
- acute MI and HR
*HR not measurable, rhythm irregular and chaotic
NO P wave, QRS not measurable
Ventricular fibrillation (V-fib) Treatment - correct answers-*CPR, ACLS, Defibrillation
*EPI
Asystole - correct answers-CPR, ACLS, EPI
CVP - correct answers-how much volume is in the right atrium
- right side
- measure with patient at a 45 degree angle and straight edge on JVD with 2 rulers
INCREASED = needs volume
DECREASED = fluid overload (fluid restriction)
Cardiac Output - correct answers-heart rate x stroke volume
amount of blood the heart pumps in a minute
(4-6L)
Ejection Fraction - correct answers-*55-75%
amount of blood the left ventricle pumps out
Stroke Volume - correct answers-The volume of blood pumped from a ventricle of the heart in one beat
Preload - correct answers-amount of blood returning
- causes stretch
*Sterlings Law
Afterload - correct answers-resistance the heart pumps against
Pulmonary Artery Pressure (PAP) - correct answers-*left side
