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A 74-yr old womn is admitted to the telemetry unit for placement of a permanent pacemaker because of sinus bradycardia. A priority goal for the client within 24 hours after insertion of a permanent pacemaker would be to
maintain cardiac conduction stability;
to prevent dysrhythmias; should have ECG until proper functioning is verified.
Characteristics of atrial fibrillation
irregular QRS interval, no definite P waves before QRS, and ventricular rate greater than 100 bpm
proper hand placement for chest compression during CPR is essential to reduce the risk of..
rib fracture; which may lead to pneumothorax and other internal injuries; (vomiting may be just due to distention of stomach)
Cardioversion: key points to do (3)
- use a conducting agent between skin and paddles
- call clear before discharging electrical current
- record delivered energy and resulting rhythm
A client who has been given CPT is transported by ambulance to emergency department. One of the most often recommended for determining effectiveness of CPR is noting:
- pupillary reaction;
- best indication of whether oxygenated blood has reached the brain:
- pupils that remain widely dilated and don't react to light probably indicate that serious brain damage has occured
Use of epinepehrine during resuscitation in the ED, primarily administered because of ability to
enhance myocardial contractility (improve cardiac activity)
- for adrenergic receptors: acts to strengthen and speed HR as well as increasing impulse conduction from atria to ventricles;
- also dilates bronchioles and constrict arterioles (not cardiac specific)
CPR compression-to-ventilation ratio:
When performing external chest compression on adult during CPT, the rescuer should depress the sternum
1.5 to 2 in
AHA for basic cardiac life support recommends that after establishing unresponsiveness, you should
call for emegency assistance; an effort to get emergency personnel and AED on scene
The nurse understands that the estimated max time anyone can be without cardiopulm function, and still not experience permanent brain dmg is
4 to 6 mins
When performing Heimlich maneuver to conscious adult victim, rescuer delivers inward and upward thrusts specifically
below xiphoid process and above umbilicus
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