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NUR 436 Midterm Exam Questions and Answers Latest Update
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NUR 436 Midterm Exam Questions and Answers Latest Update
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NUR 436 Midterm Exam Questions andAnswers Latest Update
Focused assessment of children and adults related to circulation, airway, breathing.
(ABC) - Answer-Respirations: rate, depth, ease, labored breathing, rhythm
Assume tripod position, position child so that secretions drain, provide humidified
oxygen
P wave - Answer-- the atria contracting
- slow calcium channels used in the SA node
P-R interval - Answer-0.12-0.2 seconds
- the signal goes from the AV node to bundle of His
- From the beginning of the p wave to the beginning of the QRS complex
QRS complex - Answer-ventricular depolarization
- fast acting sodium channels <0.10
QT interval - Answer-should be <0.44
T wave - Answer-repolarization of the ventricles
SA Node - Answer-the Pacemaker
- Another method is to count the number of small squares between one R-R interval ->
Divide this number into 1500 to get the HR
Artifact - Answer-a distortion of the baseline and waveforms seen on the ECG
Normal Sinus rhythm - Answer-60-100 bpm
Sinus brady - Answer-< 60 bpm
Sinus tachy - Answer-101-200 bpm
SA node and atria - Answer-60-100 bpm
AV node and Bundle of His - Answer-40-60 bpm
Bundle branches and Purkinje Fibers - Answer-20-40 bpm
Premature atrial contractions - Answer-random early P wave that triggers a QRS
complex
,Supraventricular Tachycardia (SVT) - Answer-any ectopic focus above the bundle of
His, prolonged will cause a decreased CO because the HR is > 180 bpm
- Vagal manuvers
- carotid massage
- coughing
- Adenosine
- synchronized cardioversion
Atrial flutter - Answer-F waves look like spikes, SAWTOOTH, slow ventricular response
by slowing down the atria
- want to induce an AV block through calcium channel blockers and Beta blockers
Atrial Fib - Answer-looks like chaos, most common type of dysrhythmia, decreased CO
and cause clots (emboli)
- Ca Blockers
- B Blockers
- Digoxin
- Coumadin (Warfarin)
- electrical cardio version to convert back to normal sinus rhythm
- AV node ablation
- permanent ventricular pacing
Junctional Rhythm - Answer-AV node to the bundle of His known as the AV junction
- They result because the SA node fails to fire or the signal is blocked
- When this occurs, the AV node becomes the pacemaker of the heart
- Bradycardia
- this produces an abnormal P wave that occurs just before or after the QRS complex or
that is hidden in the QRS complex
- The impulse usually moves normally through the ventricles
- The P wave is abnormal in shape and inverted, or it may be hidden in the QRS
complex
- Short PR interval
First Degree Heart Block - Answer-the PR interval is prolonged but it is consistent in
length and there is always a QRS complex after
- Not serious, can be asx, no treatment
Second Degree AV Block Type one (Wenckebach) - Answer-longer longer drop
- bradycardia
- Atropine to speed up HR
- pacemaker
Second Degree AV Block Type Two (Mobitz) - Answer-Randomly dropped QRS
complex but there is still a P wave
- poor prognosis and progresses to Third Degree block normally
- do not use Atropine
, - pacing
Third Degree AV Block - Answer-no relationship between the P wave and QRS complex
- Do not use Atropine
- not effective
- need pacemaker as soon as possible.
- Transcutaneous pacing
Ventricular Tachycardia - Answer-looks like a bunch of Vs
- Torsades de Pointes
- Three or more PVCs
VTACH W/O PULSE - Answer-CPR and defibrillation
Ventricular Fibrillation - Answer-*your child is trying to write cursive
- CPR AND DEFIBRILLATION
Asystole - Answer-total absence of ventricular electrical activity
- DO NOT defibrillate
- CPR, EPI, ADEN
- VASOPRESSIN
- intubation
Pulseless electrical activity (PEA) - Answer-a situation in which organized electrical
activity is seen on the ECG, but there is no mechanical heart activity and the patient has
no pulse
Syncronized Cardioversion - Answer-choice therapy for pt. with Ventricular
Tachydysrhythmias
- Sedate the pt. for this
transcutaneous pacemaker (TCP) - Answer-used to provide adequate HR and rhythm to
the patient in an emergency situation
- Placement of the TCP is a noninvasive
- temporary procedure used until a transvenous pacemaker is inserted or until more
definitive therapy is available.
Placement of leads - Answer-Smoke over Fire -> Left
Clouds over Grass -> Right
Mother Earth in Center
Ventilators - Answer-- assist-control (AC)
- synchronized intermittent mandatory ventilation (SIMV)
- pressure support ventilation (PSV)
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