FISDAP Cardiology Exam Study Guide Solved 100%

Intrinsic rates - Answer SA node - 60 - 100 bpm AV junction - 40 - 60 bpm Purkinje network - 20 - 40 bpm Lidocaine doses - Answer 1-1.5 mg/kg, second dose 0.5-0.75 mg/kg Unstable VT tx - Answer Should be treated with synchronized cardioversion Hypotension, decreased LOC, shock, chest pain Stable VT tx - Answer IV/IO Adenosine 6mg; 12mg (followed by rapid saline flush) If ineffective, procainamide (20-50mg/min or amiodarone (150mg IV/10min) Consider antiarrhythmic infusion Definition of second degree type 2 (mobitz type II) - Answer Conduction usually occurs in bundle of His (bundle branches); appears as one or more P waves not followed by QRS (indicates SA node impulse was not conducted by ventricles) Causes - ischemic heart disease, anterior wall MI, infectious heart diseases Action of nitroglycerin - Answer Vasodilator; relaxes smooth muscle in vasculature, bronchial, uterine, and intestinal muscle; reduces preload and afterload, decreasing workload of the heart and myocardial oxygen demand Sino atrial dysrhythmias in lead 2 - Answer Premature atrial complex (PAC), supraventricular tachy (SVT), preexcitation (early depolarization of ventricles), a-fib, a flutter, wandering atrial pacemaker (WAP), multifocal atrial tachy (MAT) ST elevation in V3 and V4 MI location? - Answer Anterior wall MI S/S of thoracic aortic dissection - Answer Abrupt onset of constant, unbearable pain described as tearing or ripping and sharp, stabbing, or knifelike Definition of CO - Answer Cardiac output - amt of blood pumped by ventricle in 1 minute (normal 5-6 L/min) Stroke volume - amt of blood pumped by either ventricle in single contraction (normal 60 - 100 mL) CO = SV x HR(heart rate) Causes of CHF - Answer Coronary artery disease (CAD, buildup of plaque in coronary arteries) *Left ventricular failure (left ventricle fails, blood backs up into the left atrium, left atrium swells {can cause atrial dysrhythmia}, pulmonary veins cannot pump into left atrium, pressure in pulmonary vessels increases, forcing fluid from pulmonary capillaries across alveolar walls into alveoli, causes pulmonary edema, impairs diffusion of oxygen and CO2) Right ventricular failure (right ventricle fails, blood backs up into right atrium, pressure rises in right atrium, blood backs up into superior & inferior venae cavae, delays venous return, causes organs to become congested with blood; as venous pressure increases fluid is forced thru the capillary walls into body's tissues, causing edema) Cor Pulmonale - Answer RVF caused by pulmonary disease; usually result of COPD (pulmonary HTN is increased pressure in pulmonary arteries, so right ventricle has to work harder to overcome the pressure, causes RV to fail) S/S of pulmonary embolism and causes - Answer Causes - blood clot (DVT common), fat embolism from broken bone, amniotic fluid embolism, air embolism S/S - sudden dyspnea and cyanosis that is not resolved with oxygen therapy, sharp chest pain Sodium Bicarb dose - Answer 1 mg / KG slow IVP; repeat 0.5 mg / kg ; same initial for peds, no repeat Management of CP, SOB and nausea - Answer Decrease respiratory distress and work of breathing, maintain adequate oxygenation and perfusion, attempt to decrease workload of the heart