Chapter 16 cardiovascular emergencies

thromboembolism

A blood clot that has formed within a blood vessel and is floating within the bloodstream.

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

Increased heart rate and increased stroke volume

angina

Pain in the heart region caused by lack of oxygen Lasts no more than 15 minutes

smallest branches of veins

venules

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.

During CPR when to transport

6-9 shocks delivered 3 consecutive "no shocks delivered" with CPR Regains pulse

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? A. Encourage the patient to chew the tablet to increase its effectiveness. B. Place the medication under the tongue and have the patient swallow it. C. Administer the medication sublingually and allow it to dissolve or absorb. D. Wait 15 minutes and reassess the patient's blood pressure prior to administering another dose.

Administer the medication sublingually and allow it to dissolve or absorb

Which of the following medications is commonly given to patients with chest pain to prevent blood clots from forming or getting bigger? a. furosemide (lasix) b. aspirin c. oxygen d. metoprolol (Toprol)

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.

Hypertension w/ s/s

Systolic > 140 Diastolic > 90 sudden severe headache, strong bounding pulse, ringing in ears, nausea and vomiting, dizziness, nose bleed, pulmonary edema, altered mental status

Atherosclerosis

a disease of the arteries characterized by the deposition of plaques of fatty material on their inner walls.

An acute myocardial infarction (AMI) occurs when: A. myocardial tissue dies secondary to an absence of oxygen. B. the heart muscle progressively weakens and dysfunctions. C. coronary artery dilation decreases blood flow to the heart. D. the entire left ventricle is damaged and cannot pump blood.

a. myocardial tissue dies secondary to an absence of oxygen.

Narrowing of the coronary arteries caused by a buildup of fatty deposits is called: a. angina pectoris b. arteriosclerosis c. acute ischemia D. atherosclerosis

atherosclerosis.

Which of the following is a major difference between angina pectoris and AMI? a. AMI is caused by myocardial ischemia b. anginal pain typically subsides with rest c. nitroglycerin has no affect on angina pectoris d. pain from AMI subsides within 30 minutes

b Anginal pain typically subsides with rest.

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? a. unstable angina b. dissecting aortic aneurysm c. acute myocardial infarction d. hypertensive emergency

b. Dissecting aortic aneurysm

Which of the following blood vessels transports oxygenated blood? a superior vena cava b pulmonary arteries c inferior vena cava d pulmonary veins

d Pulmonary veins

Which of the following signs or symptoms would you NOT expect to encounter in a patient with congestive heart failure? a. hypertension and tachycardia b. hypotension and flat jugular veins c. the presence of rales in the lungs d. trouble breathing while lying down

b. Hypotension and flat jugular veins

acute coronary syndrome (ACS)

chest pain and other signs and symptoms associated with cardiac ischemia

The ability of cardiac muscle cells to contract spontaneously without a stimulus from a nerve source is called: a excitability. b contractility. c impulsivity. d automaticity.

d automaticity

Common signs and symptoms of a hypertensive emergency include: a. pallor, cool skin and a temporary loss of hearing b. syncope, weak pulse and bleeding from the ears c. tachycardia, pain behind the ears and weakness d. a bounding pulse, a severe headache, and dizziness

d. a bounding pulse, a severe headache, and dizziness.

infarction

death of tissue

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

delivers high-energy shocks, similar to an AED.

v-fib

disorganized electrical activity

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.

When obtaining a 12-lead ECG, the patient should be: a. in semi-fowlers position with legs crossed b. in a supine position with legs uncrossed c. in semi-fowlers position with arms raised d. in a supine position with legs elevated

in a supine position with legs uncrossed.

The AED is MOST advantageous to the EMT because:

it delivers prompt defibrillation to patients with ventricular fibrillation.

ischemia

lack of blood flow

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.

v-tach

rapid HR 150-200

risk factors for atherosclerosis

smoking, high blood pressure, elevated cholesterol level, diabetes, lack of exercise, obesity

lumen

space within a tubular part or organ, such as the space within a blood vessel

Hypertension can lead to

stroke or a dissecting aortic aneurysm