NUR 431L FINAL EXAM (ACLS)
QUESTIONS WITH COMPLETE
ANSWERS
shock and CPR are the primary interventions - Answer-V-fib/pulseless V-tach-->
*Epinephrine
-1 mg IV/IO q 3-5 minutes
*amiodarone
-300 mg IV/IO for first dose
-150 mg IV/IO 2nd dose - Answer-V-fib/pulseless V-tach: meds
*epinephrine
-1 mg IV/IO q 3-5 minutes - Answer-Asystole/PEA: meds
1) Airway/breathing
2) Oxygen
3) IV access
4) EKG
5) Identify/treat causes
6) Assess adequate perfusion - Answer-first thing to do when tachycardia is identified
(HR>150)
*AT LEAST 1 OF THE FOLLOWING
•Hypotension
•Ongoing chest pain
•Altered mental status
•Signs of shock
•acute heart failure - Answer-Signs of poor perfusion:
*Synchronized Cardioversion
*adenosine
-6mg rapid IV push
-12 mg (if required) - Answer-tachycardia with poor perfusion
-SVT= "Regular narrow complex tachycardia
-A-fib= "Irregular narrow complex tachycardia"
-V-tach (monomorphic)= "Regular wide complex tachycardia"
-V-tach/ Torsades (polymorphic)= "Irregular wide complex tachycardia" - Answer-
possible rhythms for tachycardia with adequate perfusion
, *Vagal Maneuvers
*adenosine
-6mg rapid IV push
-12 mg (if required) - Answer-treatment for SVT= "Regular narrow complex tachycardia"
*sotalol (Beta Blockers)
-100mg over 5 minutes
*amiodarone
-first dose: 150mg over 10mns
-maintenance dose: 1mg/mn for first 6 hours
-expert consult - Answer-treatment for A-fib= "Irregular narrow complex tachycardia"
*Amiodarone Infusion
-150mg over 10mns
*Procainamide
-20-50mg/minute
-max dose of 17mg/kg
-drug therapy
-synchronized cardioversion - Answer-V-tach WITH a pulse-->
*DO NOT SHOCK
-CPR
-epi - Answer-Asystole/PEA-->
-identify and treat the underlying cause
-we give meds
-transvenous pacing is considered if all other measures fail - Answer-Bradycardia-->
-identify and treat the underlying cause
-synchronized cardioversion
-meds - Answer-Tachycardia-->
-Check carotid pulse for 5-10 seconds. (chest compressions should begin no longer
than 10 sec later)
-If no pulse- begin CPR with chest compression (30:2) until an AED arrives .
-If you witness the patient collapse, activate the EMS first, then begin CPR. If you find a
patient unresponsive, give 5 cycles of CPR then activate the EMS system.
-Start compressions ASAP due to unknown amount of down time.
-Recheck pulse after 5 cycles of CPR (approx. 2 min)
-Switch compressors every 2 minutes to prevent fatigue - Answer-circulation in a code
QUESTIONS WITH COMPLETE
ANSWERS
shock and CPR are the primary interventions - Answer-V-fib/pulseless V-tach-->
*Epinephrine
-1 mg IV/IO q 3-5 minutes
*amiodarone
-300 mg IV/IO for first dose
-150 mg IV/IO 2nd dose - Answer-V-fib/pulseless V-tach: meds
*epinephrine
-1 mg IV/IO q 3-5 minutes - Answer-Asystole/PEA: meds
1) Airway/breathing
2) Oxygen
3) IV access
4) EKG
5) Identify/treat causes
6) Assess adequate perfusion - Answer-first thing to do when tachycardia is identified
(HR>150)
*AT LEAST 1 OF THE FOLLOWING
•Hypotension
•Ongoing chest pain
•Altered mental status
•Signs of shock
•acute heart failure - Answer-Signs of poor perfusion:
*Synchronized Cardioversion
*adenosine
-6mg rapid IV push
-12 mg (if required) - Answer-tachycardia with poor perfusion
-SVT= "Regular narrow complex tachycardia
-A-fib= "Irregular narrow complex tachycardia"
-V-tach (monomorphic)= "Regular wide complex tachycardia"
-V-tach/ Torsades (polymorphic)= "Irregular wide complex tachycardia" - Answer-
possible rhythms for tachycardia with adequate perfusion
, *Vagal Maneuvers
*adenosine
-6mg rapid IV push
-12 mg (if required) - Answer-treatment for SVT= "Regular narrow complex tachycardia"
*sotalol (Beta Blockers)
-100mg over 5 minutes
*amiodarone
-first dose: 150mg over 10mns
-maintenance dose: 1mg/mn for first 6 hours
-expert consult - Answer-treatment for A-fib= "Irregular narrow complex tachycardia"
*Amiodarone Infusion
-150mg over 10mns
*Procainamide
-20-50mg/minute
-max dose of 17mg/kg
-drug therapy
-synchronized cardioversion - Answer-V-tach WITH a pulse-->
*DO NOT SHOCK
-CPR
-epi - Answer-Asystole/PEA-->
-identify and treat the underlying cause
-we give meds
-transvenous pacing is considered if all other measures fail - Answer-Bradycardia-->
-identify and treat the underlying cause
-synchronized cardioversion
-meds - Answer-Tachycardia-->
-Check carotid pulse for 5-10 seconds. (chest compressions should begin no longer
than 10 sec later)
-If no pulse- begin CPR with chest compression (30:2) until an AED arrives .
-If you witness the patient collapse, activate the EMS first, then begin CPR. If you find a
patient unresponsive, give 5 cycles of CPR then activate the EMS system.
-Start compressions ASAP due to unknown amount of down time.
-Recheck pulse after 5 cycles of CPR (approx. 2 min)
-Switch compressors every 2 minutes to prevent fatigue - Answer-circulation in a code
