EKG
What do you call a rhythm that includes more than 3 runs of PVCs?
Vtach
Name at least two nursing interventions when administering vasopression
use a central line!!
monitor B/P
I & O
Weights
Na+ & K+
Vitals, advanced monitoring
Which lab is the best indicator of shock?
Lactic Acid
The patient has an under-dampened wave form on their arterial line monitor. What could be the cause of this?
stiff tubing
long tubing
hypothermia
tachycardia/dysrhythmias
The patients blood pressure is 99/64. What is their MAP?
SBP + (2)DBP / 3
75.66
Name at least 2 causes of PSVT
Can occur in health individuals without heart disease
•Stimulants, Catecholamines
•Electrolyte Abnormalities
•Heart Disease
Name 2 signs of digoxin toxicity
Headache, dizziness, fatigue, confusion, acute psychosis, bradycardia, SA/AV block, blurred vision, yellow tinge, halos, nausea, vomiting & anorexia (check lab values)
Name two things that happen in the compensatory stage
increased blood sugar
vascular shunting
decreased perfusion
sodium and water retention
increased HR
etc.
The patient is 24 hours post CABG and develops a fever and has low urine output. What would be priority for the nurse to obtain?
blood cultures
What are typical cues for endocarditis?
Muscle aches, fever, petechiae, tachycardia, dyspnea, night sweats
The patient is experiencing symptomatic bradycardia. Name 1 medication that could be given.
Atropine
Name two medications that the nurse would anticipate administering for cardiogenic shock
nitroglycerin
Dopamine
Dobutamine
Norepinephrine-VERY low dose if used
fluids
diuretics
The patient with obstructive shock has an elevated d-dimer. Why would this lab value be elevated?
Physical impairment that leads to inadequate circulatory blood flow
Causes; Cardiac Tamponade, Trauma, pericarditis, autoimmune, post heart surgery, PE, Tension Pneumothorax
Name at least 2 nursing interventions post cardiac cath with a femoral access
neurovascular checks
patient positioning/bed rest
push IVF
What length of sinus pause is concerning?
•2 or <2 second Pauses are normal especially when sleeping and infrequent
•>2 seconds is NOT normal, especially if it frequently occurs
What is the noticeable abnormality with a junctional rhythm?
P Waves: inverted, absent, or right after QRS complex
Typically bradycardia
Name a medication that would be considered for administration in response to Vtach
Medications: Amiodarone, Lidocaine (both are anti-arrhythmics)
The patient with a C4 spinal cord injury is experiencing hypotension, bradycardia, and tachypnea. What are they most likely experiencing?
Neurogenic Shock
Which labs should be assessed prior to a cardiac cath?
BUN/CR
clotting factors
Troponin
What is a typical cause of endocarditis?
Staph infection& bacterial migration around valve (artificial valve, damaged valve)-From dental work, invasive devices, IV drugs
Name 1 possible intervention for sustained PSVT
•May be abated using: Vagal Maneuvers (first if stable)
•Heart Rate >150 and symptomatic: Emergent Cardioversion
•Medications: Adenosine (2nd/unstable)
Which 2 electrolyte imbalances could lead to torsades dysrhytmia?
Mag or K+
The patient has noticeable mottling, change in LOC and oozing is noted from their central line site. What stage of shock are they in and which organ is involved related to these cues.
Refractory
Liver
The patient is placed on a heparin drip prior to their cardiac cath. What lab is most important for the nurse to monitor?
PTT
What are typical cues of pericarditis?
Sharp substernal pain/pleurtic pain on inspiration*, diffuse ECG Changes, ST elevations on all leads, Fever, SOB, Tachycardia, Troponin may be elevated, cough