Emergency Nursing Orientation 3.0: Cardiovascular Emergencies Part I Part II

A patient has stable, monomorphic ventricular tachycardia. To perform synchronized cardioversion with a biphasic defibrillator and convert this dysrhythmia, which energy setting should be used first?

100 joules

Which sign or symptom is not expected in a patient with acute heart failure?

Bilateral wheezing

In addition to cardiopulmonary resuscitation, sodium bicarbonate is the treatment for cardiac arrest caused by which disorder?

Tricyclic antidepressant overdose

Which cardiac biomarker may result in a more timely and definitive diagnosis of myocardial injury?

Troponin

Drugs from which category reduce preload and afterload?

Vasodilators

Which rhythm is a common cause of sudden cardiac arrest?

Ventricular tachycardia

Which disorder is likely to produce a delta wave on the cardiac monitor?

Wolff-Parkinson-White syndrome

Which intervention is used to treat a patient with ventricular fibrillation who has an implantable cardiac defibrillator?

Apply hands-free adhesive patches in the anterior-posterior position and defibrillate.

Which statement accurately describes the pathogenesis of atherosclerosis?

Atherosclerosis affects the small arteries and arterioles.

Calcium channel blockers are indicated to treat which dysrhythmia?

Atrial fibrillation

Which dysrhythmia has an irregularly irregular ventricular response

Atrial fibrillation

Which dysrhythmia results from the continuous stimulation of two conduction pathways in the atrioventricular node?

Atrial fibrillation

A preexcitation syndrome, such as Wolff-Parkinson-White syndrome, results from which conduction pattern?

Atrial impulses bypass the typical electrical pathway and activate the ventricular myocardium directly.

In which dysrhythmia does the P wave disappear or occur just before or after the QRS complex?

Junctional escape rhythm

The left circumflex branch supplies which area of the heart?

Lateral wall of the left ventricle

Which electrocardiogram leads reflect the inferior wall?

Leads II, III, and aVF

Which leads reflect ischemic changes in the right coronary artery?

Leads II, III, and aVF

Which statement does not accurately characterize nitroglycerin (Nitrostat) administration?

Monitor the patient's vital signs every 2 hours while giving intravenous nitroglycerin.

Patients with which type of premature complexes require close monitoring?

Multifocal premature ventricular complexes

After an acute myocardial infarction, which cardiac biomarker is released first?

Myoglobin

Which drug is administered to treat acutely decompensated heart failure?

Nesiritide (Natrecor)

Which drug reduces preload and afterload?

Nitroglycerin (Nitrostat)

A patient presents with a headache, blurred vision, and a blood pressure of 280/150 mm Hg. Which drug is the most effective in rapidly managing this patient's disorder?

Nitroprusside (Nitropress)

For a patient with suspected acute coronary syndrome, which agent is not part of the recommended management?

Nitroprusside (Nitropress)

A man, age 42, presents to the emergency department with sharp, severe chest pain that increases with inspiration. In addition, he has a fever. The nurse immediately obtains a 12-lead electrocardiogram tracing, which demonstrates ST-segment elevation in all leads except aVR and V1. Based on the history and electrocardiographic findings, what is the most likely diagnosis?

Pericarditis

In the PAAS mnemonic for performing automated external defibrillation, what does the P stand for?

Power Pulse

In which dysrhythmia does an impulse originate in the atrioventricular junction before the next expected sinus impulse?

Premature junctional complex

In which dysrhythmia does a compensatory pause commonly occur?

Premature ventricular complex

Which disorder can initiate atrial flutter?

Pulmonary embolism

Which disorder is potentially reversible if the cause is immediately treated?

Pulseless electrical activity

When performing right-sided electrocardiography, which lead should you place at the fifth intercostal space in the right midaxillary line?

RV6

A man, age 65, presents with chest pain and changes on his 12-lead electrocardiogram tracing. Which change suggests an acute myocardial infarction?

ST-segment elevation greater than 1 mm in two or more contiguous leads

A transcutaneous pacemaker is most likely an intervention for which dysrhythmia?

Second-degree atrioventricular block, type II

Which type of block causes one P wave to precede each QRS complex until a QRS complex is dropped in a regular pattern?

Second-degree atrioventricular block, type II

Which patient is having a hypertensive emergency?

A patient with a blood pressure of 190/150 mm Hg, headache, and blurred vision

Which disorder results from the inflammation, rupture, or erosion of atheromatous plaque in the coronary arteries?

Acute coronary syndrome

You should expect to administer ibuprofen (Motrin) to a patient with which disorder?

Acute coronary syndrome

For a patient who is suspected of having an aortic dissection, which intervention is appropriate?

Administer a beta-blocker to control the heart rate.

Which drug may be used to convert new-onset atrial fibrillation?

Amiodarone (Cordarone)

A patient with electrocardiogram changes in leads V3 and V4 that reflect an infarction is experiencing an injury to which area of the heart?

Anterior

A blockage of the left anterior descending coronary artery causes the infarction of which part of the left ventricle?

Anterior wall

Damage to which area of the heart is most likely to result in severe heart failure?

Anterior wall

Hyperkalemia-induced cardiac arrest requires which treatment in addition to cardiopulmonary resuscitation?

Calcium chloride

Atropine is most likely to restore adequate perfusion in which situation?

Cholinergic-induced bradycardia

A woman, age 52, is found unresponsive, apneic, and pulseless at her desk an hour after returning from lunch. What is the most likely cause of her cardiac arrest?

Coronary heart disease

Which method delivers nonsynchronous energy to the myocardium?

Defibrillation

An unstable patient with polymorphic ventricular tachycardia requires which electrical treatment with a biphasic defibrillator?

Defibrillation at 200 joules

Which medication is a first-line agent for managing cardiac arrest?

Epinephrine (Adrenalin)

Which medication is the first one administered to a patient with pulseless electrical activity (PEA)?

Epinephrine (Adrenalin)

Which medication should be administered during the resuscitation of a patient with ventricular fibrillation?

Epinephrine (Adrenalin)

Which drug is used to manage a patient with a dissecting aneurysm?

Esmolol (Brevibloc)