Chapter 16 HW & Quiz: Cardiovascular Emergencies

Common signs and symptoms of a hypertensive emergency include:

A bounding pulse, a severe headache, and dizziness

Which of the following is NOT a common sign or symptom associated with malfunction of an implanted cardiac pacemaker?

A rapid heart rate

Which of the following would cause the greatest increase in cardiac output?

Increased heart rate and increased stroke volume

Angina pectoris occurs when:

Myocardial oxygen demand exceeds supply

When preparing to obtain a 12-lead ECG, the "LL" and "RL" electrodes should be placed:

On the thighs or ankles

The EMT should use an AED on a child between 1 month and 8 years of age if:

Pediatric pads and an energy-reducing device are available

Your EMS team is performing CPR on a 60-year-old male in cardiac arrest. You connect the AED, push the analyze button, and receive a "no shock advised" message. You should:

Perform CPR for 2 minutes and reassess

Which of the following blood vessels transports oxygenated blood?

Pulmonary Veins

The only vein(s) in the body that carry oxygenated blood is/are the:

Pulmonary veins.

About _____ minutes after blood flow is cut off, some heart muscle cells begin to die.

30

A patient with a left ventricular assist device (LVAD) tells you that the device's pump flow is continuous. Which of the following should you expect to encounter during your assessment?

Absence of a palpable pulse

A patient tells you that he has a left ventricular assist device (LVAD). Which of the following conditions should you suspect that he has experienced?

Acute Myocardial Infarction

Cardiogenic shock can occur within 24 hours of a(n):

Acute myocardial infarction

A 66-year-old female with a history of hypertension and diabetes presents with substernal chest pressure of 2 hours' duration. Her blood pressure is 140/90 mm Hg, her pulse is 100 beats/min and irregular, her respirations are 22 breaths/min, and her oxygen saturation is 92%. The patient does not have prescribed nitroglycerin, but her husband does. You should:

Administer oxygen, give her 324 mg of aspirin, and assess her further

Which of the following represents the MOST appropriate method of assisting a patient with his or her prescribed nitroglycerin tablet or spray?

Administer the medication sublingually and allow it to dissolve or absorb

When, for a brief period of time, heart tissues do not get enough oxygen, the pain is called:

Angina.

Which of the following is a major difference between angina pectoris and AMI?

Anginal pain typically subsides with rest

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?

Aspirin

A 49-year-old male presents with an acute onset of crushing chest pain and diaphoresis. You should:

Assess the adequacy of his respirations

____________ allows a cardiac muscle cell to contrast spontaneously without a stimulus from a nerve source.

Automaticity.

You and your partner have achieved return of spontaneous circulation (ROSC) in a patient who was in cardiac arrest. An ALS unit will arrive in less than 2 minutes. The patient remains unresponsive and has slow, irregular breathing. Further treatment for this patient should include:

BVM ventilation at 10-12 breaths/min and assessment of oxygen saturation

You and your partner arrive at the scene of a middle-aged man who collapsed about 5 minutes ago. He is unresponsive, apneic, and pulseless. Bystanders are present, but have not provided any care. You should:

Begin high-quality CPR and apply the AED as soon as possible

In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest:

Delivers high-energy shocks, similar to an AED

Which of the following signs is commonly observed in patients with right-sided heart failure?

Dependent Edema

A 66-year-old woman presents with a stabbing pain in the middle of her chest that radiates to her back. She tells you that the pain suddenly began about 30 minutes ago and has been severe since the onset. She has a history of hypertension, but admits to being noncompliant with her antihypertensive medications. When you assess her, you find that her blood pressure is significantly higher in her left arm than it is in her right arm. What do these signs and symptoms MOST likely indicate?

Dissecting aortic aneurysm

Prior to defibrillating a patient with an AED, it is MOST important that you:

Ensure that no one is touching the patient

The main legal risk in using the AED is:

Failing to deliver a shock when one is needed

Risk factors for AMI that cannot be controlled include:

Family history

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure?

Hypotension and flat jugular veins

After the AED has delivered a shock, the EMT should:

Immediately resume CPR

When obtaining a 12-lead ECG, the patient should be:

In a supine position with legs uncrossed

A patient in cardiac arrest is wearing an external defibrillator vest, which is interfering with effective chest compressions. The EMT should:

Remove the battery from the monitor and then remove the vest

Most AEDs are set up to adjust the voltage based on the impedance, which is the:

Resistance of the body to the flow of electricity

Deoxygenated blood from the body returns to the:

Right Atrium

The electrical impulse generated by the heart originates in the:

Sinoatrial Node

______________ is the maximum pressure exerted by the left ventricle as it contracts.

Systolic blood pressure.

A dissecting aortic aneurysm occurs when:

The inner layers of the aorta become separated.

A patient with atherosclerotic heart disease experiences chest pain during exertion because:

The lumen of the coronary artery is narrowed and cannot accommodate increased blood flow

Nitroglycerin is contraindicated in patients:

Who have experienced a head injury

Defibrillator pads are placed on the patient's chest:

With one pad to the left of the upper sternum and the other pad just to the right of the left nipple

An acute myocardial infarction (AMI) occurs when:

myocardial tissue dies secondary to an absence of oxygen.

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called:

atherosclerosis

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called:

automaticity

Prior to attaching the AED to a cardiac arrest patient, the EMT should:

dry the chest if it is wet

Signs and symptoms of a hypertensive emergency would MOST likely be delayed in patients who:

have chronic hypertension

The AED is MOST advantageous to the EMT because:

it delivers prompt defibrillation to patients with ventricular fibrillation.

At 0500 hours, you respond to the home of a 76-year-old man complaining of chest pain. Upon arrival, the patient states that he had been sleeping in the recliner all night due to indigestion, when the pain woke him up. He also tells you he has taken two nitroglycerin tablets. His vital signs are as follows: respirations, 16 breaths/min; pulse, 98 beats/min; blood pressure, 92/76 mm Hg. He is still complaining of chest pain. What actions should you take to intervene?

provide high-flow oxygen

In general, a maximum of _____ dose(s) of nitroglycerin is/are given for any one episode of chest pain.

three