CCRN Cardiac

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CCRN Cardiac
2014-03-17 20:26:46

CCRN cardiac review
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  1. What are the three most common causes of Metabolic Acidosis?
    ARF, Lactic Acidosis & DKA
  2. Why is diastolic BP so important?
    It shows what the capillary blood flow is.
  3. What is pulse pressure a measurement of?
    Left ventricular performance
  4. What is the renal dose of Dopamine?
    Trick question- there is no renal dose. 2.5mcgs is a vasodilating dose.
  5. What happens to HR and ECG in a RCA- IWMI(Inferior wall MI)?
    Bradycardia and Heart block
  6. What determines Ventricular Function?
    Preload, Contractility and Afterload
  7. What should you think when you hear a S3 heart sound?
    Emergency- patient if volume overloaded
  8. What should you think when you hear a S4 heart sound?
    Every person who has a MI will have this sound but it can only be heard when the patient is in SR
  9. What is normal PA pressure?
  10. What is the normal Wedge(PWCP)?
  11. What is normal CO?
    4-8 L/min
  12. What is normal CI?
    2.5-4 L/min
  13. What is normal CVP?
  14. What determines SVO2?
    CO/CI, H&H, Oxygenation and Metabolic Demand
  15. What leads should be monitored?
    Lead II and MCL1 or V1
  16. Why should you monitor 2 leads?
    Location and "p"wave analysis
  17. What ECG changes appear in Hypokalemia?
    Flat T wave with prominent U wave, ST segment flattening, Prolonged QT interval and ST segment depression
  18. What ECG changes appear in hyperkalemia?
    • If:
    • >5.5- tall, narrow, peaked Twaves
    • >6.5- QRS widens
    • >8- Wide QRS and P wave barely visable
  19. What is the treatment for Hyperkalemia?
    • Remove= Kayexelate or HD
    • Shift K= insulin and D50, NaHCO and Ca
    • The calcium is given to protect the heart
  20. What ECG changes appear in hypocalcemia?
    • Prolonged QT and Prolonged ST segment
    • Torsades de Pointes
  21. What ECG changes appear in hypercalcemia?
    • agonal or asystole
    • Shortened QT and ST segment
  22. What ECG changes appear in hypomagnesaemia?
    • Torsades de Pointes
    • -prolonged QT
    • -broad, flattened Twave
    • - dysrhythmias
  23. What ECG changes appear in hypermagnesaemia?
    • agonal to asystole
    • -PR, QT prolonged
    • -prolonged QRS
  24. What is CAD?
    Flow limiting lesions
  25. What is the number 1 risk factor for CAD?
  26. What are the clinical manifestations of CAD?
    HF, Angina, Unstable Angina, AMI, Sudden death
  27. What are the functions of an IABP?
    • Decreases afterload
    • Increases coronary perfusion
    • So in increases myocardial oxygen supply and decreased demand
  28. What is an absolute contraindication for an IABP?
    Aortic Insufficency
  29. What do you monitor for with an IABP?
    • Vascular exam
    • Timing
  30. What are the 6 P's of the vascular assessment?
    • Pain
    • Pulse
    • Pallor
    • Polar
    • Paresthesia
    • Paralysis
  31. On an ECG what leads show an inferior MI?
    II, III, and AVf
  32. How is a STEMI diagnosed?
    Clinical presentation, ECG, enzymes
  33. What does ST elevation in all leads mean?
  34. What are the clinical presentations of Left Ventricular failure?
    • Tachycardia
    • Tachypnea, dyspnea, orthopnea, PND
    • Left sided S3
    • Displaced MPI
    • Cough
    • Oliguria
    • Weakness, fatigue
    • Mental confusion
    • Murmur MR
  35. What are the clinical presentations of Right ventricular failure?
    • JVD
    • HJR
    • Dependent edema
    • Heave at sternum
    • Hepatomegaly
    • Anorexia, nausea, vomiting, abd pain
    • Ascites
    • Nocturia
    • Weakness, fatigue
    • Weight gain
    • Murmur TR
    • Right sided S3
  36. What is the management of an Aortic aneurysm?
    • Control BP
    • Repair- stent or surgical
  37. What does a ST segment depression show?
  38. What does an ST segment elevation show?
    Current of injury