ANATOMY & PHYSIOLOGY
Where is the correct placement for the left leg (LL or red) lead?
Left lower rib cage (remember smoke over fire, white on the right) - 8th interspace, left midclavicular line)
What is the correct first treatment for 1st degree AV block?
Determine the underlying cause
What is the characteristic of a 2nd degree AV block type 1?
You find your patient to be in ventricular fibrillation, what is the treatment for this rhythm?
Defibrillation
What causes the heart valves to open and close?
Change in pressures in the atria and ventricles
What EKG change is characteristic of muscle tremors in your patient?
Uneven, coarsely jagged appearance that will obscure waveforms on the EKG tracing
What is the most common cause of sinus arrhythmia?
Respiratory cycle in children and young adults
Your patient is found to have asymptomatic sinus tachycardia, what is the correct initial nursing action?
Determine underlying cause
What are the indications for atropine administration?
If the patient is symptomatic and bradycardic.
What ion is primarily responsible for myocardial contraction?
Sodium
What waveform on the EKG represents ventricular repolarization?
T wave, the ST segment represents early ventricular repolarization and the U wave represents late ventricular repolarization
What is the difference between sinus exit block and sinus arrest?
Sinus block resumes on time after pause, sinus arrest doesn't resume on time after pause
Sinus block is a disorder of conductivity whereas sinus arrest is a disorder of automaticity
What is a common cause of oversensing in a temporary transcutaneous pacemaker?
Sensitivity is set too high
You observe ST segment elevation on your patient's cardiac monitor, what is your priority nursing action?
Assess for chest pain and obtain a 12 lead EKG stat
What is the correct treatment for a patient in a 3rd degree AV block?
Pacing
Your charge nurse tells you that your patient had a myocardial infarction that affected his left ventricle, which coronary artery are you suspecting has died?
Left anterior descending and/or the left circumflex artery
What is the characteristic of a 1st degree AV block?
Rhythm is regular with a prolonged PR interval (>0.20)
What is the function of the fibrous pericardium?
You found your patient to be in torsades de pointes, what is the correct pharmacological treatment?
Magnesium sulphate
What diagnostic procedure is considered "gold standard" for coronary artery lumen pathology?
Angiogram
Which phase of the cardiac cycle is the myocardium perfused by coronary arteries?
Ventricular depolarization - during this event the ventricles are contracting (systole) and are squeezing the coronary arteries thus perfusing the myocardium
What is the primary cause of paroxysmal junctional tachycardia?
Digitalis toxicity
Where does the relative refractory period occur on the EKG?
Between the depolarization of the ventricles (QRS) and the repolarization of the ventricles (T wave) - coincides with ST segment. For the atria it is between the P wave (atrial depolarization) and the QRS wave (atrial repolarization occurs while ventricles depolarize)
You are looking at your patient's monitor at the nursing station and see your patient go into a life-threatening arrhythmia, what is your priority nursing action?
Check your patient, assess their level of consciousness and vital signs.
What are the causes of undersensing?
Sensitivity set too low, pacing catheter out of position or lying in infarcted tissue, pacemaker set on asynchronous rate