Exam (elaborations)
NR341 Test 2 – Questions & Proper Solutions (100%)
- Course
- Institution
NR341 Test 2 – Questions & Proper Solutions (100%)
[Show more]
Content preview
NR341 Test 2 – Questions & Proper Solutions (100%)Sinus bradycardia Right Ans - <60 bpm
-normal for athletes
-two types: stable/ unstable
S.Bradycardia drug options Right Ans - -Atropine= increase HR
-Dopamine *most common*
-Epi/ norepi
S. Brady option besides drugs Right Ans - Electrical pacing
-transcutaneous
-permanent
S. Brady: atropine Right Ans - -Anti cholinergic
-1st drug used for Brady
-increase SA and AV node conduction
-0.5 mg IV push (same dead/alive)
-pupil dilation
-anticholinergic: drymouth/mucous membranes
S. Brady: Dopamine Right Ans - Ordered as infusion
-titrate to HR
-increases HR and BP
*most common drug used for sinus brady*
S.Brady: Epi Right Ans - used as infusion
-very short half-life
S. Brady: Electrical Right Ans - Pacing
-SubQ first
-TV- trans-venous pacemaker
-permanent PM
Atrial paced: image Right Ans -
ventricular paced Right Ans -
Atrial and Ventricular Paced: Right Ans -
,Permanent Pacemakers Right Ans - -keep away from magnets
-batteries last up to 10 years
-need maintenance and care
Pacemaker restrictions Right Ans -
Paced beats Right Ans - If pacer doesn't see atrial (p-wave) or ventrical (Q-
wave) spike, it will for for them.
3 problems with pacers:
-Failure to pace
-failure to capture
-failure to sense
Failure to pace: image Right Ans -
Failure to pace Right Ans - Fails to deliver pacemaker spike
-cause: batt failure/ oversensing/ lead disconnected or broken
Failure to capture: image Right Ans -
Failure to capture Right Ans - Pacemaker spike present with no QRS
-60-80 mAMP to capture (external)
-caused by low battery or poor connection
Failure to sense: image Right Ans -
Failure to sense Right Ans - -RF for R on T phenom.
-can put into lethal D-rhythm.
-cause: incorrect lead placement/ low batt./ set to high
Causes of issues with Paced beats Right Ans - -lead (need replaced/ or
placed correctly)
-Battery life
Pacemaker indication types Right Ans - -Temporary
-Permanent
,Temporary indication for PM Right Ans - -any condition that has caused or
potentially can cause a slow HR
Permanent PM indicator Right Ans - -Heart block
-slow HR
-Fast HR
-Cardiomyopathy
Diagnostics/ procedures for Cardiac Alterations Right Ans - -Cardiac
enzymes (troponin)
-12 lead EKG
-Echocardiogram
-BNP
How does Ischemia look on telemetry Right Ans - -ST depression
How does injury look on telemetry Right Ans - -ST elevation
Pacemaker post op care Right Ans - -is PM capturing/ pacing/ sensing to its
settings
-Pt is immobilized (avoid arm above shoulder)
-prophylactic anti-B (surgery)
-inspection of surgical site
PM Pt and caregiver teaching Right Ans - -HCP follow up for function tests
(phone interrogation)
-signs of infection at site
-keep incision dry for 4 days post op
-avoid lifting arm above shoulder
-avoid direct blows to pacer
-avoid electric generators
-no MRI
-Microwave ovens do not interfere
-avoid antitheft devices in doorways, walkthru don't stand in them
-travel is not restricted/ inform security, do not place wand directly over PM
-monitor pulse, contact HCP if under set rate
-carry info card of PM and current drugs
-Medic alert ID band
-consider joining PM support group
, Sinus tachycardia Right Ans - >100 bpm
-can see distinguishable P-wave
Sinus Tachy:image Right Ans -
Causes of S. tachy Right Ans - -activity (normal)
-decreased BP/ hypovolemia (compensatory)
-dehydration
-temp (infection)
-pain
Prior to meds for S.TAchy Right Ans - -fix factor that caused
-meds will knock out ability of body to respond and compensate
Meds:
-BB
-CCB
Supraventricular Tachycardia (SVT) Right Ans - >160 w/ QRS (narrow)
-indistinguishable P-wave from T-wave
S/S:
-decreased CO
-pale
-fear/ anxiety
-rapid/ thready pulse
SVT: image Right Ans -
SVT Tx Right Ans - 1-vaso vagal
2- Stable: Adenosine IV push with T-gate flush as fast as possible
-6/ 12/ 12 mg => will push into A.flutter ( a more stable d.rhythm)
3- Unstable = sedate =>Synchronized cardiovert
Adenosine (Adenocard) Right Ans - Antidysrhythmic agent. Slows
conduction time through the AV node, interrupts AV node pathways to restore
NSR.
-Converts supraventricular tachycardia (SVT) to sinus rhythm. Rapid IV (1-2
seconds) push, flush immediately with normal saline.
-IV site: AC- 6mg followed by 20mL NS, can repeat with 12mg
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller LeCrae. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $24.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
78252 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now