med surg exam 2

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Editor), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved from https://doi.org/10.1007/978-1-4020-6162-2 Regarding the information about the editor: It is correct The editor's name isn't necessary The editor's full first name should be provided "Editor" should be "Ed."

"Editor" should be "Ed."

rarely occurs in a healthy heart. It is associated with CAD, hypertension, mitral valve disorders, pulmonary embolus, chronic lung disease, cor pulmonale, cardiomyopathy, hyperthyroidism, and the use of drugs, such as digoxin, quinidine, and epinephrine.

Atrial flutter

represent atrial depolarization followed by repolarization. The PR interval is variable and not measurable. The QRS complex is usually normal. There is usually some AV block in a fixed ratio of flutter waves to QRS complexes because the AV node can delay signals from the atria.

Atrial flutter

How wide should the header and footer be? 1 inch (2.5 cm) 1.5 inches (3.81 cm) Authors may use Microsoft Word's default settings, which are usually 0.49 inches (1.24 cm)

Authors may use Microsoft Word's default settings, which are usually 0.49 inches (1.24 cm)

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Ed.), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved from https://doi.org/10.1007/978-1-4020-6162-2 Regarding the page range: It is correct Page range should cite the specific pages from which the author has quoted/paraphrased (e.g., pp. 635, 640, 643) Missing "pages" (e.g., pages 633-645) Missing "pp." (e.g., pp. 633-645)

Missing "pp." (e.g., pp. 633-645)

refers to a rhythm that starts in the SA node at a rate of 60 to 100 beats/min and follows the normal conduction pathway (Fig. 35.10). The P wave is normal, precedes each QRS complex, and has a normal shape and duration. The PR interval is normal. The QRS complex has a normal shape and duration. implies that cardiac electrical activity is normal.

Normal sinus rhythm

Godfrey, Donald. (2005) Adapting Historical Citations to APA Style. Journal of broadcasting & electronic media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the author's name: -It is correct -Only the initial should be provided for the first name: Godfrey, D. -There should be a comma after the period, but everything else is correct

Only the initial should be provided for the first name: Godfrey, D.

SA is the

Pacemaker of the heart

Name the symptoms of anemia (She said she did want us to know this)

Palpitations (increased, bounding pulse); tachycardia, increased pulse pressure, systolic murmurs, intermittent claudication, angina, HF, MI

_________ can occur with Wolff-Parkinson-White (WPW) syndrome or "preexcitation" with extra conduction or accessory pathways.

Paroxysmal Supraventricular Tachycardia

is a dysrhythmia starting in an ectopic focus anywhere above the bifurcation of the bundle of His (Fig. 35.13). Identifying the ectopic focus is often hard even with a 12-lead ECG since it requires recording the dysrhythmia as it starts.

Paroxysmal supraventricular tachycardia (PSVT), also known as supraventricular tachycardia (SVT) or atrial tachycardia

If patient is in atrial fibrillation, you first need to.....

Perform a vagal move (ex. Raise legs above the pts head, then put them back down, or tell them to bare down like their pooping) Next step would be to give drugs (ex. Amiodorone) If that still doesn't work, perform synchronized cardioversion

Pulmonary edema is diagnosed by

Pink, frothy sputum (I believe this is very important) you see pulmonary edema in LEFT sided HF

_______________ is the total absence of ventricular electrical activity. Occasionally, P waves are seen. No ventricular contraction occurs because depolarization does not occur. Patients are unresponsive, pulseless, and apneic. Asystole is a lethal dysrhythmia that needs immediate treatment. VF may masquerade as asystole. Always assess the rhythm in more than 1 lead. The prognosis of a patient with asystole is extremely poor.

asystole

If a patient comes in and you suspect a dysrhythmia, a priority would be to...

get IV access early (if their cardiac output is decreased, it would be hard to get an IV started) as the IV is being put in (or after it is put in), get their electrolyte levels through labs also obtain triponin and CKMB to assess for heart muscle damage at that point

treatment for sinus tachycardia

give fluids, take away the pain, vagal maneuver, beta blockers, calcium channel blockers, syncronization (in extreme cases)

Common disease states associated with sinus bradycardia are

hypothyroidism, increased intracranial pressure, and inferior myocardial infarction (MI).

Common causes of PEA (Pulseless electrical activity) include

hypovolemia, hypoxia, metabolic acidosis, hyperkalemia, hypokalemia, hypoglycemia, hypothermia, toxins (e.g., drug overdose), cardiac tamponade, thrombosis (e.g., MI, pulmonary embolus), tension pneumothorax, and trauma. KNOW THESE (H's and T's)

What do you do for a pt with sinus bradycardia?

if due to drugs, these may have to be held, stopped or reduced if pt has symptoms, give IV atropine (anticholinergic drug) if atropine is ineffective, transcutaneous pacing or a dopamine or epinephrine infusion are options. The patient may need a permanent pacemaker.

***What acid base imbalance puts you at high risk for dysrhythmia?** IMPORTANT

increased hydrogen ions bc isn't exchanging oxygen well RESPIRATORY ACIDOSIS

with defibrillation, you want to use the ________ energy possible first

lowest (this is to decrease lower post-shock dysrhythmias)

Decrease impulse conduction through AV node

magnesium (av block)

sinus tach symptoms.....

many of the same symptoms of bradycardia because the ventricles arent filling with blood completely before its being ejected out to the body, so less perfusion is happening

Causes for paroxysmal supraventricular tachycardia (PSVT) in a normal heart?

overexertion, emotional stress, deep inspiration, and stimulants, such as caffeine and tobacco. PSVT is also associated with rheumatic heart disease, digitalis toxicity, CAD, and cor pulmonale.

With _________, prolonged episode and HR greater than 180 beats/min will cause decreased CO because of reduced stroke volume. Manifestations include hypotension, palpitations, dyspnea, and angina.

paroxysmal supraventricular tachycardia (PSVT)

What causes sinus tachycardia (HR 101-180)?

physiologic and psychologic stressors, such as exercise, fever, pain, hypotension, hypovolemia, anemia, hypoxia, hypoglycemia, myocardial ischemia, heart failure (HF), hyperthyroidism, anxiety, and fear. It can be an effect of drugs, such as epinephrine, norepinephrine (Levophed), atropine, caffeine, theophylline, or hydralazine. In addition, many over-the-counter cold remedies have active ingredients (e.g., pseudoephedrine) that can cause tachycardia.

The alignment of text should be: Whatever the author prefers Justified (the words are spread equally across the line so that every line of text ends at the right margin) Left-aligned with a ragged right edge (the text begins at the left margin and the spacing at the right margin is uneven) Right-aligned (the text begins at the right margin and the spacing at the left margin is uneven) Next

Left-aligned with a ragged right edge (the text begins at the left margin and the spacing at the right margin is uneven)

Ventricular tachycardia symptoms:

MI, CAD, significant electrolyte imbalances, cardiomyopathy, long QT syndrome, drug toxicity, and central nervous system disorders. **It can occur in patients who have no evidence of heart disease.**

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Ed.), International handbook on giftedness (pp. 633-645). Springer, Dordrecht. Retrieved fromhttps://doi.org/10.1007/978-1-4020-6162-2 Regarding the electronic retrieval location for this resource: It is correct The electronic retrieval details aren't necessary "Retrieved from" isn't necessary and therefore only the DOI should appear in the reference

"Retrieved from" isn't necessary and therefore only the DOI should appear in the reference

Choose the correct format for citing personal communication: (J. Johnson, personal communication, September 3, 2013) (J. Johnson, email, September 3, 2013) (Johnson, personal communication, September 3, 2013)

(J. Johnson, personal communication, September 3, 2013)

Choose the correct format for citing personal communication: (Johnson, personal communication, September 3, 2013) (J. Johnson, email, September 3, 2013) (J. Johnson, personal communication, September 3, 2013)

(J. Johnson, personal communication, September 3, 2013)

Which of the following choices is the correct formatting for a citation to personal communication? (Johnson, email, September 3, 2019) (J. Johnson, personal communication, September 3, 2019) (J. Johnson, email, para. 4) (Johnson, personal communication, para. 4)

(J. Johnson, personal communication, September 3, 2019)

Choose the correct in-text citation format for a direct quotation: (Johnson, 2013, p. 4) (Johnson, 2013) (2013, p. 4)

(Johnson, 2013, p. 4)

Choose the correct in-text citation format for a direct quotation: (2013, p. 4) (Johnson, 2013, p. 4) (Johnson, 2013)

(Johnson, 2013, p. 4)

If the cited resource doesn't provide a publication or copyright date, which of the following options is correct? (Lastname, no date, p. X) (Lastname, n.d., p. X) No citation is necessary

(Lastname, n.d., p. X)

If the only way to cite a source is through a secondary source citation, which of the following citations is the correct formatting? In the examples below, Lastname1 refers to the author of the text you read, whereas Lastname2 refers to the secondary author quoted by Lastname1. (Lastname2, year, as cited in Lastname1, year, p. X) (Lastname2, year, p. X) (Lastname1, year, p. X) (Lastname2, as cited in Lastname1, year, p. X)

(Lastname2, year, as cited in Lastname1, year, p. X)

If the cited resource doesn't have an identified author, what information should be provided in the in-text citation? (Anonymous, year, p. X) (The first few words of the title of the resource, year, p. X) No citation is necessary

(The first few words of the title of the resource, year, p. X)

If the author's last name and the year of publication are provided in the signal phrase before a quotation, what information is required in the parenthetical citation? For example: "Lastname (year) noted that, "quotation text" (what should be here?). The URL where the resource was retrieved (page X) or (paragraph X) (p. X) or (para. X) No citation is necessary

(p. X) or (para. X)

What is the target INR for warfarin? (this is how you measure effectiveness of the warfarin)

2.5-3.5

Normal cardiac output is

4-6 L/min

What is normal ejection fraction?

55-65%, pts with HFrEF have a level that is less than 40%

A digital object identifier (DOI) is:

A unique alpha-numeric identifier that provides a persistent link to the resource's location

In the patient with supraventricular tachycardia, which assessment indicates decreased cardiac output?

Abdominal distention and tachypnea

The typeface and font size should be: Serif (e.g., Times New Roman) or Sans serif (e.g., Arial typeface in a legible size (e.g., 12 pt, 11 pt.) Accessible and widely available. Used consistently throughout the entire paper. All of the above

All of the above

When citing a direct quotation from an ebook that doesn't have page numbers, which of the following is the correct approach to indicating the location of the information within the ebook? A paragraph number A heading plus a paragraph number within the section An abbreviated heading in quotation marks if the original heading is long Any of these options, depending on how the information is presented within the book.

Any of these options, depending on how the information is presented within the book.

Page margins should be: At least 1 inch (2.54 cm) on all sides At least 0.5 inch (1.27 cm) top and bottom and at least 0.75 right and left. At least 1 inch (2.54) on all sides, unless more space is needed for a table or figure, in which case the margins may be reduced

At least 1 inch (2.54 cm) on all sides

is characterized by a total disorganization of atrial electrical activity because of multiple ectopic foci. It results in loss of effective atrial contraction (Fig. 35.15, B). The dysrhythmia may be paroxysmal (i.e., beginning and ending spontaneously) or persistent (lasting more than 7 days).1 Atrial fibrillation is the most common, clinically significant dysrhythmia with respect to morbidity and mortality rates and economic impact. Its prevalence increases with age.

Atrial fibrillation

usually occurs in a patient with underlying heart disease, such as CAD, valvular heart disease, cardiomyopathy, hypertensive heart disease, HF, and pericarditis. It often develops acutely with thyrotoxicosis, alcohol intoxication, caffeine use, electrolyte problems, stress, and heart surgery.

Atrial fibrillation

________ patients have an increased risk for stroke because thrombi (clots) can form in the atria from the stasis of blood. Warfarin or another anticoagulant is given to prevent stroke in patients who have atrial flutter.

Atrial flutter

_______ have a vital role in maintaining BP stability during normal activities. They are sensitive to stretching and, when stimulated by an increase in BP, send inhibitory impulses to the sympathetic vasomotor center. SNS inhibition results in decreased HR, decreased force of contraction, and vasodilation in peripheral arterioles. When __________ sense a fall in BP, the SNS is activated. The result is constriction of the peripheral arterioles, increased HR, and increased contractility of the heart. In long-standing hypertension, the baroreceptors become adjusted to elevated BP levels and recognize this level as their new "normal."

Baroreceptors

Before giving any antidysrhythmic drug........ THIS QUESTION SEEMED IMPORTANT TO KNOW ALL OF IT, POSSIBLE SELECT ALL THAT APPLY

Before giving any antidysrhythmic drug, PERFORM A THOROUGH ASSESSMENT with a complete physical assessment, health history, and medication history. Assess for contraindications, cautions, and drug interactions. Obtain a baseline ECG. Assess vital signs, heart and lung sounds, and pulse rate, rhythm, and quality. Assess for signs and symptoms associated with decreased CO because of the dysrhythmia, such as restlessness, syncope, chest pain, dyspnea, and crackles. Review laboratory studies, including electrolytes, and liver and kidney function tests. When giving antidysrhythmics, closely monitor the ECG and vital signs, especially BP and pulse rate. Continue to perform an ongoing physical assessment. Monitor laboratory studies as needed. Give specific instructions for each drug. Teach the patient that oral forms are often better tolerated if taken with food and fluids to help decrease GI upset. Tell patients to avoid alcohol, caffeine, and tobacco.

Choose the correct formatting for a level 1 section heading: Centered, uppercase and lowercase text Flush left, uppercase and lowercase text Flush left, boldface, lowercase text Centered, boldface, uppercase and lowercase text

Centered, boldface, uppercase and lowercase text

What asssessment findings would show decreased perfusion systemically? [dysrhythmia]

Cold, clammy skin diaphoresis numbness and tingling pallor (pulses, cap refill)

treatments for paroxysmal supraventricular tachycardia (PSVT)?

Common vagal maneuvers include Valsalva, carotid massage, and coughing. IV adenosine is the drug of choice to convert PSVT to a normal sinus rhythm (Fig. 35.14). This drug has a short half-life (10 seconds) and is well tolerated.6 IV β-blockers and calcium channel blockers (e.g., diltiazem, verapamil) are options. If the patient becomes hemodynamically unstable, synchronized cardioversion is done.7 Cardioversion is discussed on p. 770.

Ramifications of not perfusing the brain well? (dysrhythmias)

Decreased level of consciousness and confusion Dizziness and syncope Restlessness and anxiety (not enough oxygen)

involves the passage of an electric shock through the heart to depolarize the myocardial cells. The goal is that after repolarization, the SA node will be able to resume the role of pacemaker.

Defibrillation

What is the correct line spacing? Single-spaced throughout, including block quotations and references Single-spaced throughout, but double-spaced between paragraphs Double-spaced throughout, but block quotations and references can be single-spaced Double-spaced throughout, including block quotations and references

Double-spaced throughout, including block quotations and references

This can locate accessory pathways and determine the effectiveness of antidysrhythmic drugs.

Electrophysiologic study (EPS)

This study is done to identify what kind of dysrhythmia the patient is having, can identify the causes of heart blocks, tachydysrhythmias (greater than 100 bpm), brady dysrhythmias (less that 60 bpm), and syncope

Electrophysiologic study (EPS)

What are 5 important things to know about adenosine (adenocard)?

Explain that the patient may feel chest pressure after the medication is given. • Injection site should be as close to the heart as possible (e.g., antecubital area). • Give IV dose rapidly (over 1 to 2 sec) and follow with a rapid 20-mL normal saline flush. Use a stopcock setup to make sure adenosine gets to the heart quickly. • Monitor patient's ECG continuously. Brief period of asystole is common (Fig. 35.14). • Assess the patient for flushing, dizziness, chest pain, or palpitations.

You can perform defibrillation on a patient who is asystole (flat lining) T or F

FALSE there has to be some type of electrical stimulation for defib to work, you need to begin CPR

The title of a document is located only on the title page in APA Style. True False

False

True or false: The introduction should be labelled with a level 1 heading (e.g., "Introduction" centred, boldface, and capitalized).

False

When providing two or more authors' names in a parenthetical citation, use "and" to join the names, not the ampersand symbol. For example, (Lastname, Lastname, and Lastname, year, p. X). True False

False

In-text citations to paraphrased text must provide page/paragraph numbers. True False, though the APA rules permit authors to provide them.

False, though the APA rules permit authors to provide them.

Choose the correct formatting for a level 2 section heading: Centred, boldface, uppercase and lowercase text Centred, uppercase and lowercase text Flush left, boldface, uppercase and lowercase text Flush left, uppercase and lowercase text

Flush left, boldface, uppercase and lowercase text

ECG characteristics of paroxysmal supraventricular tachycardia (PSVT)?

HR is 151 to 220 beats/min. The rhythm is regular or slightly irregular. The P wave may have an abnormal shape or be hidden in the preceding T wave. The PR interval may be shortened or normal. The QRS complex is usually normal.

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of broadcasting & electronic media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the journal title: It is correct It should be italicized and in title case (i.e., all major words capitalized) It should be italicized It should be in title case (i.e., all major words capitalized)

It should be italicized and in title case (i.e., all major words capitalized)

List the interventions for dysrhythmias

If unresponsive, assess circulation, airway, and breathing (CAB). • If responsive, monitor airway, breathing, and circulation (ABC). • Apply O2 via nasal cannula or nonrebreather mask. • Take baseline vital signs, including O2 saturation. • Obtain 12-lead ECG. • Begin continuous ECG monitoring. • Identify underlying rate and rhythm. • Identify dysrhythmia. • Establish IV access. • Obtain baseline laboratory studies (e.g., CBC, electrolytes). Ongoing Monitoring • Monitor ABCs, vital signs, level of consciousness, O2 saturation, and heart rhythm. • Anticipate need for antidysrhythmic drugs and analgesics. • Anticipate need for intubation if respiratory distress occurs. • Anticipate need to begin advanced cardiovascular life support (e.g., CPR, defibrillation, transcutaneous pacing).

Where are in-text citations placed in an APA Style essay? In round brackets after quotations or paraphrases In the reference list After the closing punctuation mark at the end of a sentence At the bottom of each page

In round brackets after quotations or paraphrases

Where are in-text citations placed in an APA Style essay? In the reference list In round brackets after quotations or paraphrases After the closing punctuation mark at the end of a sentence At the bottom of each page

In round brackets after quotations or paraphrases

Where are page numbers located? In the bottom left footer In the bottom right footer In the top left header In the top right header

In the top right header

Where do page numbers appear in an essay? In the bottom right footer In the top left header In the bottom left footer In the top right header

In the top right header

Where do page numbers appear in an essay? In the top left header In the top right header In the bottom right footer In the bottom left footer

In the top right header

Beta 1 positive chronotropic effect =

Increased HR

Beta 1 positive dromotropic effect =

Increased conduction

Beta 1 receptors positive inotropic effect =

Increased contractility

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of Broadcasting & Electronic Media, 49(4), 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the electronic retrieval information: It is correct It is incorrect to provide a DOI; the author should have provided the URL to the resource It is missing a retrieval date

It is correct

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of Broadcasting & Electronic Media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the issue number: It is correct It should be italicized No parentheses are necessary There should be a period, not a comma, after the closing parenthesis

It is correct

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of Broadcasting & Electronic Media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the volume number: It is correct It should not be italicized It should be provided in the same parentheses as the issue number There should be a period after the volume number

It is correct

Rogers, K. (2009). Leadership Giftedness: Is It Innate or Can It Be Developed? In L. Shavinina (Editor), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved from https://doi.org/10.1007/978-1-4020-6162-2 Regarding the date: It is correct Missing the month and day of publication There should be a comma, not a period, after the closing parenthesis

It is correct

Godfrey, D. (2005) Adapting Historical Citations to APA Style. Journal of broadcasting & electronic media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the publication date: It is correct It is missing the month and day of publication It is missing a period after the closing parenthesis, but is otherwise correct

It is missing a period after the closing parenthesis, but is otherwise correct

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Ed.), International handbook on giftedness (pp. 633-645). Houten, NT: Springer, Dordrecht. Retrieved fromhttps://doi.org/10.1007/978-1-4020-6162-2 Regarding the publisher details: It is correct It is not necessary to note the publisher location and name in references to electronic book chapters The country of publication needs to be spelled out in full (e.g., Houten, Netherlands) It is not necessary to note the location (e.g., Houten, NT)

It is not necessary to note the location (e.g., Houten, NT)

Rogers, K. (2009). Leadership Giftedness: Is It Innate or Can It Be Developed? In L. Shavinina (Editor), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved from https://doi.org/10.1007/978-1-4020-6162-2 Regarding the title of the chapter: It is correct It should be in sentence case (i.e., first word, first word of subtitle, and all proper nouns capitalized) It should be in sentence case and italicized It should be italicized

It should be in sentence case (i.e., first word, first word of subtitle, and all proper nouns capitalized)

Godfrey, D. (2005). Adapting Historical Citations to APA Style. Journal of broadcasting & electronic media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the article title: It is correct It should be italicized It should be in sentence case (i.e., only the first word and proper nouns capitalized) It should be italicized and in sentence case

It should be in sentence case (i.e., only the first word and proper nouns capitalized)

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Ed.), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved fromhttps://doi.org/10.1007/978-1-4020-6162-2 Regarding the book title: It is correct It should be in title case (i.e., all major words capitalized) It should be italicized It should be italicized and in title case

It should be italicized

The first line of every new paragraph should be: Left-aligned and indented one tab space (usually 0.5 inch or 1.27 cm) Left-aligned without any indentation Right-aligned

Left-aligned and indented one tab space (usually 0.5 inch or 1.27 cm)

treatment for ventricular tachycardia

Precipitating causes (e.g., electrolyte imbalances, ischemia) must be identified and treated. If the VT is monomorphic and the patient is clinically stable (i.e., pulse is present) and has preserved left ventricular function, IV procainamide, lidocaine, or amiodarone are options. These drugs can be given if VT is polymorphic with a normal baseline QT interval. Polymorphic VT with a prolonged baseline QT interval is treated with IV magnesium, isoproterenol, phenytoin, or antitachycardia pacing (discussed later in this chapter). Drugs that prolong the QT interval (e.g., dofetilide [Tikosyn]) should be stopped. Cardioversion is used if drug therapy is ineffective. VT without a pulse is a life-threatening situation. It is treated the same as VF. Cardiopulmonary resuscitation (CPR) and rapid defibrillation are the first lines of treatment, followed by the administration of vasopressors (e.g., epinephrine) and antidysrhythmics (e.g., amiodarone) if defibrillation is unsuccessful.11

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of Broadcasting & Electronic Media, 49(4), pp. 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Regarding the page numbers: They are correct Provide just the page range (e.g., 544-547); "pp." isn't required It is not necessary to note the page range in a reference to a journal article The page numbers should provide all pages cited from within the article (e.g., pp. 544, 555, & 547), not the range of pages where the article is located in the journal.

Provide just the page range (e.g., 544-547); "pp." isn't required

_________ is characterized by elevated pulmonary artery pressure from an increase in resistance to blood flow through the pulmonary circulation.

Pulmonary hypertension (Normally the pulmonary circulation is characterized by low resistance and low pressure. In pulmonary hypertension the pulmonary pressures are high, with the mean pulmonary artery pressure greater than 25 mm Hg at rest (normal is 12 to 16 mm Hg) or greater than 30 mm Hg with exercise.)

_____________ is a situation in which organized electrical activity is seen on the ECG, but there is no mechanical heart activity and the patient has no pulse. It is the most common dysrhythmia seen after defibrillation. Prognosis is poor unless the underlying cause is quickly identified and treated.

Pulseless electrical activity (PEA)

the conduction pathway is the same as that in sinus rhythm, but the SA node fires irregularly. This often results from changes in intrathoracic pressure during breathing. The HR increases slightly during inspiration and decreases slightly during exhalation. It remains 60 to 100 beats/min. It is common in healthy adults.

Sinus arrhythmia

_____________ occurs in response to aerobically trained athletes, carotid sinus massage, Valsalva maneuver, hypothermia, increased intraocular pressure, vagal stimulation, and certain drugs (e.g., β-blockers, calcium channel blockers

Sinus bradycardia

the conduction pathway is the same as that in sinus rhythm, but the SA node fires at a rate less than 60 beats/min

Sinus bradycardia

Rogers K. (2009). Leadership Giftedness: Is It Innate or Can It Be Developed? In L. Shavinina (Editor), International handbook on giftedness (633-645). Houten, NT: Springer, Dordrecht. Retrieved from https://doi.org/10.1007/978-1-4020-6162-2 Regarding the author's name: It is correct There's a comma missing between the last name and first initial The author's full first name should be provided

There's a comma missing between the last name and first initial

The font style and size should be:

Times New Roman 12 font.

Treatment for Pulseless electrical activity (PEA):

Treatment begins with CPR, followed by drug therapy (e.g., epinephrine) and intubation. Correcting the underlying cause is critical to prognosis.

Godfrey, D. (2005). Adapting historical citations to APA Style. Journal of Broadcasting & Electronic Media, 49(4), 544-547. https://doi.org/10.1207/s15506878jobem4904_15 Aside from the missing hanging indent, this reference is now correctly formatted to the APA Style (7th ed.) rules. True False

True

In APA Style, page numbering starts at "1" on the title page. True False

True

In APA Style, page numbering starts at "1" on the title page. True False

True

In APA Style, running heads are not required in student essays unless an instructor requires them. True False

True

Rogers, K. (2009). Leadership giftedness: Is it innate or can it be developed? In L. Shavinina (Ed.), International handbook on giftedness (pp. 633-645). https://doi.org/10.1007/978-1-4020-6162-2_31 Asides from the missing hanging indent, this reference is now correct. True False

True

The year of publication should be included in parentheses when an author is named in the text and a full citation is required. For example: "Lastname (year) argued that...". True False

True

When citing one or two authors in-text, never use et al.; instead, always provide the author(s)' names.

True

When citing one or two authors in-text, never use et al.; instead, always provide the author(s)' names. True False

True

When mentioning a source with at least three authors in a sentence in either a parenthetical citation or in the sentence text, only the first author's name and et al. should be provided: "Lastname et al. (year) argued that...". True False

True

When you have ventricular fibrillation, you have to _________

Use the defibrillator because there is no pulse. (If you have vfib, you have to have dfib) Before you use the defibrillator, you need to be doing high quality CPR

Treatment of premature atrial contaction?

Withdrawal of sources of stimulation, such as caffeine or sympathomimetic drugs (e.g. epinephrine, dopamine), may be needed. β-Blockers may be used to decrease PACs.

During _____________, the atrial rate may be as high as 350 to 600 beats/min. Chaotic, fibrillatory waves replace the P waves. Ventricular rate varies, and the rhythm is usually irregular. When the ventricular rate is between 60 and 100 beats/min, it is atrial fibrillation with a controlled ventricular response. Atrial fibrillation with a ventricular rate greater than 100 beats/min is atrial fibrillation with a rapid (or uncontrolled) ventricular response. The PR interval is not measurable. The QRS complex usually has a normal shape and duration. At times, atrial flutter and atrial fibrillation coexist.1

atrial fibrillation

The goals of ___________ treatment are to decrease the ventricular response (to less than 100 beats/min), prevent stroke, and convert to sinus rhythm, if possible. Ventricular rate control is a priority. Drugs used for rate control include calcium channel blockers (e.g., diltiazem), β-blockers (e.g., metoprolol), amiodarone, and digoxin (Lanoxin).

atrial fibrillation

__________ results in a decrease in CO because of ineffective atrial contractions (loss of atrial kick) and/or a rapid ventricular response (RVR). Thrombi may form in the atria because of blood stasis. An embolized clot may move through arteries to the brain, causing a stroke. Atrial fibrillation accounts for as many as 20% of all strokes.9

atrial fibrillation

The primary goal in treatment of ______________ is to slow the ventricular response by increasing AV block. Drugs used to control ventricular rate include calcium channel blockers and β-blockers. Electrical cardioversion may be done to convert the atrial flutter to sinus rhythm in an emergency (i.e., when the patient is clinically unstable) and electively. Antidysrhythmic drugs can convert atrial flutter to sinus rhythm (e.g., ibutilide [Corvert]) or to maintain sinus rhythm (e.g., amiodarone, flecainide).6,8 Radiofrequency catheter ablation in an EPS laboratory is the treatment of choice for atrial flutter.8 The procedure involves placing a catheter in the right atrium. Low-voltage, high-frequency electrical energy is then used to ablate (or destroy) the ectopic foci. This should restore normal sinus rhythm. (Catheter ablation is discussed on p. 773.)

atrial flutter

is an atrial tachydysrhythmia identified by recurring, regular, sawtooth-shaped flutter waves that originate from a single ectopic focus in the right atrium or, less often, the left atrium

atrial flutter

5. Which patient teaching points should the nurse include when providing discharge instructions to a patient with a new permanent pacemaker and the caregiver? (select all that apply) a. Avoid or limit air travel. b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder. e. Do not use a microwave oven because it interferes with pacemaker function.

b. Take and record a daily pulse rate. c. Obtain and wear a Medic Alert ID device at all times. d. Avoid lifting arm on the side of the pacemaker above shoulder.

4. The nurse prepares a patient for synchronized cardioversion knowing that cardioversion differs from defibrillation in that a. defibrillation delivers a lower dose of electrical energy. b. cardioversion is a treatment for atrial bradydysrhythmias. c. defibrillation is synchronized to deliver a shock during the QRS complex. d. patients should be sedated if cardioversion is done on a nonemergency basis.

b. cardioversion is a treatment for atrial bradydysrhythmias.

3. In the patient with supraventricular tachycardia, which assessment indicates decreased cardiac output? a. Hypertension and dyspnea b. Chest pain and palpitations c. Abdominal distention and tachypnea d. Bounding pulses and a systolic murmur

c. Abdominal distention and tachypnea

1. A patient admitted with syncope has continuous ECG monitoring. An examination of the rhythm strip reveals the following: atrial rate 74 beats/min and regular; ventricular rate 62 beats/min and irregular; P wave normal shape; PR interval lengthens progressively until a P wave is not conducted; QRS normal shape. The priority nursing intervention would be to a. give epinephrine 1 mg IV push. b. prepare for synchronized cardioversion. c. observe for symptoms of hypotension or angina. d. apply transcutaneous pacemaker pads on the patient.

c. observe for symptoms of hypotension or angina.

6. Important teaching for the patient scheduled for a radiofrequency catheter ablation procedure includes explaining that a. ventricular bradycardia may be induced and treated during the procedure. b. catheter will be placed in both femoral arteries to allow double-catheter use. c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms. d. general anesthetic will be given to prevent the awareness of any "sudden cardiac death" experiences.

c. the procedure will destroy areas of the conduction system that are causing rapid heart rhythms.

Chest, neck, shoulder, back, jaw, or arm pain {why would this happen with a dysrhythmia?)

can be caused by such a low cardiac output that your coronary arteries are not being perfused coronary arteries are the first thing to be perfused in heart flow, so if there is not enough blood flow, your heart muscle will suffer and it will become painful

The faster the HR, the

cardiac output will happen less effectively. less tolerance by the body (sinus tachycardia)

2. The ECG monitor of a patient in the cardiac care unit after an MI shows ventricular bigeminy with a rate of 50 beats/min. The nurse would a. perform defibrillation. b. administer IV amiodarone. c. prepare for temporary pacemaker insertion. d. assess the patient's response to the dysrhythmia.

d. assess the patient's response to the dysrhythmia.

Premature atrial contraction can result from....

emotional stress or physical fatigue, or from caffeine, tobacco, or alcohol use. A PAC can also result from hypoxia, electrolyte imbalances, hyperthyroidism, chronic obstructive pulmonary disease (COPD), and heart disease, including CAD and valvular disease. (caused by anything that increases excitability in the body or causes acidotic state)

When providing two or more authors' names in a parenthetical citation, use "and" to join the names, not the ampersand symbol. For example, (Lastname, Lastname, and Lastname, year, p. X). T OR F?

false

(Sinus bradycardia) Symptomatic bradycardia refers to a HR that is less than 60 beats/min and causes the patient to have symptoms of inadequate perfusion What would the symptoms look like?

fatigue, dizziness, chest pain, syncope, cool, pale, slow HR, hypotensive (severe: angina, confusion, may pass out)

a contraction starting from an ectopic focus in the atrium (i.e., a location other than the SA node) sooner than the next expected sinus beat. The ectopic signal starts in the left or right atrium and travels across the atria by an abnormal pathway. This creates a distorted P wave (Fig. 35.12). At the AV node, it may be stopped (nonconducted PAC), delayed (lengthened PR interval), or conducted normally. If the signal moves through the AV node, in most cases it is conducted normally through the ventricles. QRS IS NORMAL, JUST HAPPENS REALLY CLOSE TOGETHER

premature atrial contraction (PAC)

The P wave precedes each QRS complex and has a normal shape and duration. The PR interval is normal. The QRS complex has a normal shape and duration.

sinus bradycardia (the HR is less than 60 beats/min and rhythm is regular).

blockers .....

slow things down

The problem with a high HR (sinus tach) is

the ventricles dont have enough time to refill to get enough blood for ejection

Atrial Dysrhythmias are usually less life threatening than

ventricular dysrhythmias

Treatment consists of immediate initiation of CPR and ACLS with the use of defibrillation and definitive drug therapy (e.g., epinephrine, amiodarone). There should be no delay in starting chest compressions and using a defibrillator once available.

ventricular fibrillation

_____________ is a severe derangement of the heart rhythm characterized on ECG by irregular waveforms of varying shapes and amplitude (Fig. 35.21). This represents the firing of multiple ectopic foci in the ventricle. Mechanically, the ventricle is simply "quivering," with no effective contraction, and so no CO occurs. VF is a lethal dysrhythmia.

ventricular fibrillation

· Identify common causes of dysrhythmias.·

• Accessory pathways • Cardiomyopathy • Conduction defects • Heart failure • Myocardial ischemia, infarction • Valve disease • Acid-base imbalances • Alcohol • Caffeine, tobacco • Connective tissue disorders • Drowning • Drug effects (e.g., antidysrhythmic drugs, stimulants, β-blockers) or toxicity • Electric shock • Electrolyte imbalances (e.g., hyperkalemia, hypocalcemia) • Emotional crisis • Herbal supplements (e.g., areca nut, wahoo root bark, yerba maté) • Hypoxia • Metabolic conditions (e.g., thyroid dysfunction) • Sepsis, shock • Toxins

What are the primary causes of HF?

• Cardiomyopathy (e.g., viral, postpartum, substance use) • Congenital heart defects (e.g., ventricular septal defect) • CAD, including MI • HTN, including hypertensive crisis • Hyperthyroidism • Myocarditis • Pulmonary HTN • Rheumatic heart disease • Valvular disorders (e.g., mitral stenosis)

Identify assessment findings you would find for a pt with a dysrhythmia

• Irregular rate and rhythm; tachycardia, bradycardia • Chest, neck, shoulder, back, jaw, or arm pain • Cold, clammy skin • Decreased level of consciousness, confusion • Decreased or increased BP • Decreased O2 saturation • Decreased peripheral pulses • Diaphoresis • Dizziness, syncope • Dyspnea • Extreme restlessness, anxiety • Feeling of impending doom • Nausea and vomiting • Numbness, tingling of arms • Pallor • Palpitations • Weakness and fatigue