Ch 16 (EMT)
What is the last step in cardiac monitoring?
Label each strip
To maintain consistency in monitoring and obtaining a useful ECG, there are predetermined _______________ for each electrode.
Locations
What surgery uses a balloon attached to a long, thin tube?
Percutaneous transluminal coronary angioplasty
A 56-year old man has acute myocardial infarction. Which blood vessel became blocked and led his condition.
Pulmonary ateries
Nitroglycerin is contraindicated in patients:
with a systolic blood pressure less than 100 mm Hg
Defibrillator pads are placed on the patient's chest
with one pad to the right of the upper sternum and the other pad to the left lower chest below the armpit.
Symptoms consistent with AMI
-Peripheral pulses equal -Pain severity equals with time -Pain produced by tightness or pressure
Components of good perfusion
-Well functioning heart -Adequate volume of blood -Blood vessels must be appropriately constricted to match the volume of blood available.
All of the following are common signs and symptoms of cardiac ischemia:
-chest pressure. -shortness of breath. -anxiety or restlessness
The main advantage(s) of the AED is:
-it provides quick delivery of a shock. -it is easier than performing CPR. -there is no need for ALS providers to be on scene.
What is the recommended dosage of low-dose aspirin for the patient with chest pain or discomfort?
162 mg to 324 mg. 2 tablets to 4 tablets.
What percentage of patients with an AMI do not reach the hospital alive?
40%
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
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
What does automaticity mean?
Allows a cardiac muscle to contract spontaneously without a stimulus.
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
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.
Which of the following would cause the greatest increase in cardiac output?
Increased heart rate and increased stroke volume
The complete cessation of cardiac activity (mechanical, electrical, or both) is known as
Cardiac Arrest
What is determined by multiplying the heart rate by the volume of blood ejected with each contraction?
Cardiac output
Major controllable risk factors for an AMI include:
Cigarette smoking
A 65-year old man with a suspected AMI doe not have prescribed nitroglycerin and you do not have permission from medical control to administer it. What should you do?
Complete your assessment and prepare to transport
A 56-year-old man has an acute myocardial infarction. Which of the following blood vessels became blocked and led to his condition?
Coronary arteries
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
Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger?
Hypotension and flat jugular veins
What happens to the inside of the lumen as cholesterol and calcium deposits begin to form?
The lumen begins to narrow
Common signs and symptoms of a hypertensive emergency include:
a bounding pulse, a severe headache, and dizziness.
An acute myocardial infarction (AMI) occurs when:
myocardial tissue dies secondary to an absence of oxygen.
A 59-year-old woman presents with chest pressure. She is conscious and alert, but her skin is cool, pale, and clammy. Your first step in providing care (treatment) should be:
administer 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
A patient with cardiac arrest secondary to ventricular fibrillation has the greatest chance for survival if:
defibrillation is provided within 2 minutes.
In contrast to an automatic implantable cardiac defibrillator (AICD), an external defibrillator vest:
delivers high-energy shocks, similar to an AED.
While palpating the radial pulse of a 56-year-old man with chest pain, you note that the pulse rate is 86 beats/min and irregular. This indicates
dysrhythmia
Prior to defibrillating a patient with an AED, it is MOST important that you:
ensure that no one is touching the patient.
When obtaining a 12-lead ECG, the patient should be:
in a supine position with legs uncrossed.
Where is the brachial pulse taken?
inside upper arm
The AED is MOST advantageous to the EMT because:
it delivers prompt defibrillation to patients with ventricular fibrillation.
Where is an AMI most likely to occur?
left ventricle
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.
If a patient with an implanted pacemaker is in cardiac arrest, the EMT should
place the AED pads away from the pacemaker.
Which of the following blood vessels transports oxygenated blood?
pulmonary veins
After administering a nitroglycerin tablet to a patient, the EMT should:
reassess the patient's blood pressure within 5 minutes.
