MS 2 Final Exam week 8
Terms in this set (65)
What is normal sinus evidenced by?
a regular rate, P wave followed by a QRS with a normal shape, PR interval 0.12-0.20 (Page #698)
On an EKG what do waves represent?
the p wave represents atrial depolarization, the QRS represents ventricular depolarization, the T wave represents ventricular repolarization, the ST segment indicates early ventricular repolarization, U wave is sometimes seen in the setting of hypokalemia (Page #696)
what does the sinoatrial (SA) node initiate?
the impulse that causes atrial contraction which is observed by a p wave on the electrocardiogram (EKG) (Page #696)
How to Assess heart rate ?
by counting the R-R intervals in 6 seconds and multiply by 10 or count the number of large boxes within the R-R interval and divide 300 by that number (Page #697)
what should you Instruct the client with a wearable automatic cardioverter defibrillator vest to do?
the battery is changed daily and the vest is only taken off to shower (Page #722)
what can Dysrhythmias can impair?
the heart rate and rhythm and result in a decrease in blood pressure (Page #693)
What does A prolonged QT interval do?
puts the client at risk for a lethal ventricular dysrhythmia (torsades de pointes) (Page #697)
What can Athletic training, hypothyroidism, beta-blockers and vagal stimulation (severe pain) cause?
sinus bradycardia (Page #698)
Sinus bradycardia has the same characteristics as?
normal sinus rhythm except for the rate (Page #699)
premature atrial complexes are electrical impulses in the atrium that occur before what?
the sinus node conduction; caffeine, nicotine, hypokalemia and alcohol could contribute to this (Page #700)
Sychronized cardioversion is the treatment of choice for what?
tachycardia with hemodynamic instability (Page #702)
What is Atrial flutter is known for?
its saw tooth pattern which is caused by a rapid regular atrial rate; if ventricular rate is high medications to slow the response are given (Page #702)
A high atrial and ventricular rate is observed in what irregular rhythm?
atrial fibrillation, no discernible P waves and an irregular rate and rhythm (Page #703)
What happens As the heart rate increases?
the hearts ability to fill decreases and cardiac output drops (Page #704)
Atrial fibrillation is an irregular rhythm that does what?
it decreases stroke volume and increases the risk for a cerebral vascular accident and premature death (Page #704)
When does The risk for thrombus formation increase?
in the setting of atrial fibrillation (Page #704)
When does Pooling of blood could occur?
in the setting of atrial fibrillation, increasing the risk for thrombus formation (Page #704)
Clinical manifestations of pulmonary embolism consist of?
chest pain, cough, dyspnea, hypoxemia, tachycardia, tachypnea, petechiae and restlessness (Page #704)
Alcohol, caffeine or nicotine could contribute to what?
premature ventricular contractions (Page #707)
Premature ventricular contractions could trigger what?
life threatening dysrhythmias! (Page #708)
Three or more continuous premature ventricular contractions at a rate greater than 100 beats per minute is defined as?
ventricular tachycardia (Page #708)
Ventricular fibrillation causes?
ineffective quivering of the ventricles and is not compatible with life (Page #709)
What is The treatment of choice for unconscious patients with pulseless ventricular tachycardia is?
defibrillation! (Page #709)
Ventricular fibrillation is the most common dysrhythmia for?
clients in cardiac arrest (Page #709)
The ventricular rate in ventricular fibrillation is greater than what?
300 beats per minute (Page #709)
Defribillation safety consists of what?
maintaining good contact between the skin and paddles (use a conductive medium) and confiming that no one is touching the patient (Page #715)
Clients with atrial fibrillation for an unknown period of time must receive what?
anticoagulation before cardioversion (prevents dislodgement of clots into the bloodstream) (Page #716)
Instruct patients to place cell phones how far away?
6-12 inches away from the pacemaker generator and handheld screening devices used in airports may interfere with the pacemaker (Page #720)
Pacemaker malfunction could result in what?
bradycardia and a decrease in heart rate (Page #720)
Teach the patient with a pacemaker on how to?
take their pulse (Page #725)
Instruct the patient that large magnetic devices (MRI's, large motors, handheld search devices) may cause what?
deactivation of the implantable cardiac devices (Page #725)
Heparin and coumadin may be given together until the international normalized ration (INR) is what?
therapeutic between 2-3 (Page #705)
Prepare to administer vitamin K for what toxicity?
coumadin toxicity or protamine sulfate for heparin toxicity (Page #705)
Therapeutic levels for warfarin (coumadin) when used for atrial fibrillation is?
international therapeutic ratio of 2-3.(pg#702)
Inotropic drugs affect the force of the contraction while chronotropic drugs affect what?
the heart rate(Page #693)
Atropine (an anticholinergic) is given when?
to block vagal stimulation and increase heart rate during sinus bradycardia (Page #699)
how should Adenosine must be administered?
rapidly and is used to abort tachycardia in the setting of atrial flutter or sinus tachycardia with hemodynamic instability (Page #702)
Push adenosine rapidly by ?
iV push, flush the line with 20 ml following the injection, and raise the arm to promote quick circulation (Page #702)
Tetanus prophylaxis could be prescribed following what kind of injury?
a major burn (Page #2127)
When triaging, place clients who need continuous nursing monitoring in the resuscitation category, what are the intervals of time needed to monitor them?
every 15 minutes in the emergent category, every 30 minutes in urgent and every 60 minutes in less urgent and every 120 minutes in the nonurgent category (Page #2121)
what are the different levels of triage?
Emergent triage signals that the client has a life or limb-threatening stituation; Urgent for clients who need care but who do not have a life threatening event; nonurgent can wait several hours without complications (Page #2121)
Determine the length of the oropharyngeal airway by?
measuring from the lip to the ear (Page #2123)
How to Control hemorrhage ?
by placing firm pressure over the area that's bleeding or over the artery just proximal to the site (Page #2125)
what happens to Urinary output during hemorrhage?
it decreases with hemorrhage (Page #2125)
Loss of fluid volume could lead to?
a drop in perfusion, hypovolemic shock and death! (Page #2125)
Signs of fluid volume deficit include
changes in level of consciousness, decreased urinary output, dizziness, dry mucosal membranes, hypotension, tachycardia, (Page #2125)
Delayed capillary refill could signal what?
internal bleeding in the setting of tachycardia, apprehension and falling blood pressure (Page #2125)
Signs of heat stroke include
confusion, hypotension, tachypnea and tachycardia; could progress to seizures and coma (Page #2131)
Provide pain medication, tetanus vaccination and a warm water bath for individuals suffering from
frost bite (Page #2133)
after the ingestion of caustic substances NEVER?
induce vomiting(Page #2138)
What should you Dilute corrosive poisons with?
with water or milk unless the client has airway edema, an obstruction or esophageal burns (Page #2138)
Gastric lavage is only beneficial when?
the first hour after ingestion (Page #2138)
why Administer activated charcoal?
to absorb the poison (doesn't absorb heavy metals, iron lithium or corrosives) (Page #2138)
When do we Administer 100% oxygen?
to clients who have carbon monoxide poisoning (Page #2138)
What does Alcohol do to the central nervous system ?
it depresses it(Page #2140)
What are Signs of alcohol intoxication?
include impaired coordination, slurred speech, drowsiness, uninhibited behavior; with alcohol poisoning symptoms could progress and suppress level of consciousness (stupor, comatose) (Page #2140)
What are Signs of cocaine (stimulant) overdose ?
includes tachycardia, increased blood pressure, seizures and ventricular dysrhythmias and hypervigilance (Page #2141)
how does Opioid (heroin, morphine, tramdol, meperidene, oxycodone and fentanyl) overdose look?
is associated with pupil constriction, decreased blood pressure, stupor, respiratory depression and seizures (Page #2141)
Inhalants are sniffed from?
a bag (bagging), sprayed onto the nostrils (dusting), inhaled through nose (snorting), or sniffed from a rag/cloth (huffing) (Page #2142)
Providing airway support and oxygen and monitoring hor hypotension and ventilation are ?
a priority for clients who overdosed on an inhalent (Page #2142)
Salicylate poisoning causes what?
restlessness, deafness, tinnitus, respiratory alkalosis and metabolic acidosis (Page #2143)
you should Respect the wishes of competent adults who decide to stay in an abusive environment; however, educate them on?
available resources and possible alternatives should be provided (Page #2146)
Administer a narcotic antagonist (naloxone hydrochloride [Narcan]), to?
reverse the effects of opioids (Page #2141)
provide the greatest good for the most amount of people for reverse triage;using what colors?
red tag (life threatening injuries), yellow tag (major injuries), green tag (minor injuries), black tag (expected and allowed to die) (Page #2156)
Place a black tag on clients with injuries that include what injuries?
penetrating head injuries, fixed and dilated pupils, high spinal cord injuries, burns covering > 60% of the total body surface area, profound shock and agonal respirations (Page #2156)
YOU MIGHT ALSO LIKE...
EKG/ECG Certification Study Guide For EMTs, Monitor Techs, and Certified EKG Technicians (CETs)
Pharmacology ADN Cardio
Chapter 34 - Care of Patients with Dysrhythmias
OTHER SETS BY THIS CREATOR
Hogan Med Surg 1
med surge 1 - Week 1 Key Points
MS Final Exam Week 7
MS Exam 2
THIS SET IS OFTEN IN FOLDERS WITH...
HESI - Medical Surgical Nursing
Medical- Surgery Exam 2.
HESI Medical Surgery Final Exam