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CARDIOLOGY ETC. UCH PROTOCOLS EXAM #1 QUESTIONS AND ANSWERS
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CARDIOLOGY ETC. UCH PROTOCOLS EXAM #1 QUESTIONS AND ANSWERS
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CARDIOLOGY ETC. UCH PROTOCOLSEXAM #1 QUESTIONS AND ANSWERS
How many lobes does the left lung have - Answer-2 lobes
3 things needed to needle decompress - Answer--severe resp distress
-hypotension
-unilateral absent or diminished lung sounds
OR
-Traumatic pulseless arrest w/ trauma to the trunk
What are the 3 components of becks triad - Answer--JVD
-hypotension
-muffled heart sounds
Tension Pnuemo S/S - Answer--resp distress
-subq air
-JVD
-tracheal deviation
-CP
-Pulses paradoxes
Causes of pericarditis - Answer--Ecoli
-viral and or bacterial infections
-IV drug use
Cardiac Tamponade - Answer-acute compression of the heart caused by fluid
accumulation in the pericardial cavity. Ischemia develops
Pericardium - Answer-Heart is surrounded and enclosed in a double walled sac
Tension Pnuemo landmarks - Answer--2nd intercostal space at midclavicular line or 5th
intercostal space at the midaxillary line.
* generally the site with least soft tissue overlying ribs is preferred.
Angiocath size for adult and child for decompression - Answer-Adult - longest available,
generally 10g
Child - 10-16g depending on size
Insertion site for needle decompression - Answer-insert needle at top margin of rib to
avoid neuro-vascular bundle that travels along lower margin of the rib and NOTIFY
HOSPITAL OF ATTEMPT
,Fibrous pericardium - Answer-superficial portion of the sac that fits loosely around the
heart. Tough dense connective tissue layer. Protects and anchors the heart while
preventing overfilling of the heart with blood
Pericardial Cavity - Answer-Contains a film of serous fluid which lubricates and
cushions the action of the heart. Between the parietal and visceral layers.
Pericarditis - Answer-Inflammation of the pericardium and can result in thickening and
adhesions
Treatment for pericarditis - Answer-pericardiocentisis
Pericarditis can cause what leading to cardiac tamponade - Answer-pericardial effusion
What protocol do we follow for pericarditis - Answer-Medical shock
Cardiac tamponade (swinging heart) - Answer-acute compression of the heart caused
by fluid accumulation in the pericardial cavity. life threatening and reduced cardiac
function up to complete cardiac arrest
Cardiac tamponade - pt clinical history findings - Answer--cardiothoracic surgery
-rheumatoid infection
-MI
-penetrating or blunt thoracic trauma
-cancer
Medical Shock Protocol order - Answer--Hypotension for age
-assess ABCS (look at arrest, resp distress or obstructed airway as needed)
-etiology of shock state
-treat any dysrhythmia's
-fluid 20ml/kg up to 1 liter CAN REPEAT 1X if still hypotensive
-Contact mom and dad if continued hypotension
UCH Protocol etiologies of shock - Answer--Dysrhythmia
-Myocardial ischemia
-sepsis
-hemorrhage
- anaphylaxis
-OD
-CO poisoning
-PE, MI, Ten Pnuemo
Treating Shock in Pericarditis/Tamponade protocol - Answer-Vasopressor continuous
infusion 9320 (ADULTS ONLY)
, Vasopressor infusion Protocol for Pericarditis and tamponade - Answer-Dopamine
infusion : hypotension with poor perfusion refractory to adequate fluid resus (30ml/kg)
or Brady with poor perfusion
What is a pediatric per protocol - Answer-Age less than 12 YO
Dopamine infusion dose - Answer-mix : 400mh in 250 ml NS or 800 mg in 500 ml NS to
produce concentration of 1600mcg/ml
ADULT IV/IO : 5-20 mcg/kg/min starting at 5mcg. Titrate dose up 5mcgs every 5 to a
max dose of 20 to desired effect.
When do we use the EPI drip in the vasopressor infusion protocol? - Answer-ROSC
with brady and hypotension refractory to pacing and fluid bolus
OR
ROSC with a normal HR and hypotension refractory to fluid bolus.
Myocardium - Answer-Middle layer of heart wall, muscles are layered in spiral bundles
Endocardium - Answer-Innermost layer of the heart, containing endothelial linings of
vessels. Assists with prevention of blood clots
Most common cardiomyopathy - Answer-Dilated - affecting atria and ventricles by
stretching overtime and thinning. Commonly starts in LV and can cause heart failure
Who does restrictive cardiomyopathy affect? - Answer-Older adults. Ventricles become
rigid, scar tissues replaces myocardium and atrial enlargement is a consequence.
hypertrophic cardiomyopathy - Answer-heart muscle becomes enlarged and ventricles
thicken blocking blood flow. Can occur at any age including young athletes.
Fossa Ovalis - Answer-Shallow depression where a foramen existed in utero in the
interatrial septum
Coronary sinus - Answer-responsible for draining the deoxygenated blood leaving the
myocardium from the cardiac veins. Drains into the right atrium
chordae tendineae - Answer-Heart strings - connect the tricuspid and mitral valve to the
papillary muscles to prevent the prolapse of the valves
papillary muscles - Answer-attach to the chordae tendineae to assist prevention of valve
prolapse
Stroke volume - Answer-The amount of blood ejected from the heart in one contraction.
Cardiac output - Answer-heart rate x stroke volume
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