Critical Care Midterm Exam – Questions And
Answers (Guaranteed Pass!)
Heart rate on an ECG Ans - number of complexes in 6 seconds x 10
evaluating the heart rhythm Ans - regular or irregular; look at R-R
intervals
PR interval Ans - 0.12-0.20; top of P wave to top of R wave - determine if
consistent or not
QRS complex Ans - <0.12 seconds
NSR Ans - seen in majority of patients, 60-100
SB Ans - HR<60
ST Ans - HR > 100
A-fib Ans - most frequent dysrhythmia; irregular R-R; lack of P waves
A-fib Ans -
PVCs Ans - large, bizarre, complexes that come early, followed by a
pause; associated with hypokalemia, drug toxicity, hypoxia, myocardial
ischemia, acidosis, cardiomyopathy
PVCs Ans -
VT Ans - wide complex, tachycardia, associated with structural heart
disease and electrolyte imbalance; poorly tolerated, low CO b/c no time to fill
ventricles
VT Ans -
V-fib Ans -
, V-fib Ans - chaotic, electrical activity ventricles shaking, no pulse, no CO;
ECG wavy line
Symptomatic bradycardia Ans - Will usually not be treated unless the
patient displays symptoms of hypoperfusion (hypotension, dizziness, chest
pain, changes in level of consciousness); decreased CO due to fewer ejections
Sinus tachycardia Ans - treat the cause - CCB, BB; needs close
examination of the cause of the tachycardia; decreases diastolic filling time
and EF
A-fib Ans - control the rate to enable filling and keep CO up - CCB, BB,
anticoagulants (aspirin, coumadin, xarelto); convert to NSR - not an option for
most people (amiodarone, diltiazem, cardioversion, ablation)
PVCs Ans - look for a cause and treat it - oxygen
VT Ans - check on the patient to ensure VT is real; if responsive =
"stable" - amiodarone, call a code; if unresponsive = "stable" - immediate
defibrillation and code
VF Ans - immediate defibrillation per ACLS; no such thing as a stable
patient, will progress to asystole if no interventions
70-100 Ans - Map: most accurate indicator of organ perfusion
PVC arterial curve change Ans - poor perfusion w/ this dysrhythmia;
single, non-perfused beat; waveform drops off
A-fib arterial curve change Ans - variable arterial pressure b/c of the
differences in stroke volume between each beat; irregular atrial pulsations
CVP Ans - reflects mean right atrial pressure - right heart preload
indicator and volume status; subclavian or jugular insertion; can see if patient
is fluid overloaded or fluid depleted
Low CVP intervention Ans - decreased blood returning to the heart =
fluid deficient, give fluids, vasoconstrictor
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