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Final Exam Critical Care Comprehensive – Q&A
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Final Exam Critical Care Comprehensive – Q&A1st degree AV block ✔️Ans -
Sinus Rhythm with an increased, but consistent, PR interval (>0.20 sec).
Problem in the conduction system. May progress to more severe block. Patient
usually has no symptoms and no hemodynamic changes. ✔️Ans -Describe
the characteristics of a 1st degree AV block.
Correct the cause, monitor closely; usually benign. Evaluate medication usage
for cause. ✔️Ans -How is a 1st degree AV block managed?
2nd degree Mobitz Type I: Wenkebach ✔️Ans -
Too many P waves... Faster atrial rate than ventricle. PR interval progressively
grows longer until a QRS is dropped...(Gives you a little "wink" instead... ;)
Almost always temporary. If bradycardia can lead to decreased CO. Resolves
when underlying condition corrected (MI, CAD, drug induced: beta blockers,
CCBs, digoxin). ✔️Ans -Describe the characteristics of 2nd degree Mobitz
Type I: Wenkebach.
,Correct the underlying cause; atropine, temporary pacemaker; discontinue
digoxin. ✔️Ans -How is a 2nd degree Mobitz Type I: Wenkebach
managed?
2nd degree AV block Mobitz Type II ✔️Ans -
Normal Atrial rate, slower ventricular. P waves are normal and regular;
ventricular is irregular at the dropped beat.
PR interval can be longer but regular. Normal QRS complexes.
Problem with bundle of His or bundle branches. Bradycardia may lead to
decreased CO and then decreased BP. Patient symptomatic. May progress to
more serious block. ✔️Ans -Describe the characteristics of 2nd degree AV
block Mobitz Type II.
Atropine for bradycardia, isoproterenol if very slow rate. Consider
epinephrine or dopamine as needed. ✔️Ans -How is a 2nd degree AV
block Mobitz Type II managed?
3rd degree AV block (Complete Heart Block!) ✔️Ans -
3rd degree AV block (Complete Heart Block!) ✔️Ans -
,Loss of synchrony between atrial and ventricular contractions. Potentially life-
threatening. Bradycardia leading to severely decreased CO and decreased BP.
Patient symptomatic. Digoxin toxicity a frequent cause. ✔️Ans -Describe
the characteristics of a 3rd degree AV block (Complete Heart Block!).
Atropine for bradycardia, epinephrine, isoproterenol, pacemaker ✔️Ans -
How is 3rd degree AV block (Complete Heart Block!) managed?
If the R is far from P, then you have a FIRST DEGREE!
Longer, longer, longer, drop! Then you have Wenckebach.
If some Ps don't get through, then you have Mobitz II.
If Ps and Qs don't agree, then you have a thrid degree. ✔️Ans -Name the
characteristics of each heart block using the heart block poem.
V1 (C1) Fourth intercostal space at the right sternal border
V2 (C2) Fourth intercostal space at the left sternal border
V3 (C3) Halfway between leads V2 and V4
V4 (C4) Fifth intercostal space in the midclavicular line
V5 (C5) Left anterior axillary line on the same horizontal plane as V4
V6 (C6) Left midaxillary line on the same horizontal plane as V4 and V5
RA (R) Right arm (inner wrist)
LA (L) Left arm (inner wrist)
RL (N) Right leg (inner ankle)
LL (F) Left leg (inner ankle) ✔️Ans -Describe the correct placement of
electrodes when conducting a 12 lead EKG.
60-100 bpm ✔️Ans -What is the normal adult heart rate?
0.12-0.20 seconds ✔️Ans -What is the normal PR interval?
0.08-0.12 seconds ✔️Ans -What is the normal QRS interval?
, atrial depolarization ✔️Ans -What does the P wave represent?
ventricular depolarization ✔️Ans -What does the QRS interval represent?
ventricular repolarization ✔️Ans -What does the T wave represent?
little box = 0.04 seconds
big box = 0.20 seconds ✔️Ans -Describe how to read ECG paper.
80 bpm ✔️Ans -Calculate the rate of this rhythm strip.
P wave, QRS complex, T wave, ST segment, PR interval ✔️Ans -Identify
the waveforms found in a normal ECG.
represented by the P wave ✔️Ans -In an ECG reading, which wave
represents depolarization of the atrium?
QRS complex ✔️Ans -In an ECG reading, what complex represents
depolarization of the ventricle?
The time required for the impulse to travel from the atria through the AV
node. ✔️Ans -What does the PR interval represent?
Hypokalemia ✔️Ans -If the U wave is most prominent, what condition
might the nurse suspect?
Count the number of RR intervals in the 30 large squares and multiply by 10
to determine the heart rate for 1 minute. ✔️Ans -Describe the calculation
of the heart rate using an ECG rhythm strip.
Ability of the client to tolerate the arrhythmia. ✔️Ans -What is the most
important assessment data for the nurse to obtain in a client with an
arrhythmia?
sinus bradycardia ✔️Ans -
Regular rhythm; Same characteristics as NSR except HR is ↓ 60 bpm
✔️Ans -Describe the characteristics of sinus bradycardia.
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