ACLS Practical Application - Section 3, Exams of Pharmacology

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in Pre-Course Assessment Questions And

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A patient has been resuscitated from cardiac arrest. During post-ROSC treatment, the patient becomes unresponsive, with the rhythm shown here (VT shown). Which action is indicated next? - correct answer Give an immediate unsynchronized high-energy shock (defibrillation dose) After initiation of CPR and 1 shock for ventricular fibrillation, this rhythm is present on the rhythm check (vfib shown). A second shock is given, and chest compressions are resumed immediately. An IV is in place, and no drugs have been given. Bag-mask ventilations are producing visible chest rise. What is your next action? - correct answer Give epinephrine 1mg IV/IO What action should you take immediately after providing an AED shock?

• correct answer Resume chest compressions What is the recommended compression rate for high-quality CPR? - correct answer 100 - 120 compressions per minute A patient's 12-lead ECG is transmitted by paramedics and shows a STEMI. When the patient arrives in the emergency department, the rhythm shown here is seen on the cardiac monitor (sinus rhythm 92 w/ STEMI). The patient has a moderate resolution of chest pain (5/10) after 3 doses of sublingual nitroglycerin. Blood pressure is 104/70 mm Hg. Which intervention is most important in reducing this patient's in-

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hospital and 30-day mortality rate? - correct answer Reperfusion therapy (restoring the blood flow using fibrinolytics and thrombolytics in a process called thrombolysis) A 35-year old woman presents with a chief complaint of palpitations. She has no chest discomfort, shortness of breath, or light-headedness. Her blood pressure is 120/78 mm Hg. (SVT @ 175 bpm is shown on the cardiac monitor). Which intervention is indicated first? - correct answer Vagal maneuvers A patient becomes unresponsive. You are UNCERTAIN (key word) if a faint pulse is present. The rhythm shown here (sinus bradycardia irregular rhythm) is seen on the cardiac monitor. An IV is in place. What action do you take next? - correct answer Start high-quality CPR (why yes, the Choad did write that question in order to trick you into saying transcutaneous pacing) A 45-year old woman with a history of palpitations develops light- headedness and (shocker) palpitations. She has received Adenosine 6 mg IV for the rhythm shown here (SVT irregular @ 210-220 bpm) without conversion of the rhythm. She is now extremely apprehensive. Her blood pressure is 128/70 mm Hg. What is the next appropriate intervention? - correct answer Administer Adenosine 12 mg IV

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What is the recommended depth of chest compression for an adult victim? - correct answer At least 2 inches How does complete chest recoil contribute to effective CPR? - correct answer Allows maximum blood return to the heart A patient was in refractory ventricular fibrillation. A third shock has just been administered. Your team looks to you for instructions. What is your next action? - correct answer Resume high-quality chest compressions How often should you switch chest compressors to avoid fatigue? - correct answer About every 2 minutes What action minimizes the risk of air entering the victim's stomach during bag-mask ventilation? - correct answer Ventilating until you see the chest rise You are providing bag-mask ventilations to a patient in respiratory arrest. How often should you provide ventilations? - correct answer About every 5-6 seconds

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Which action is likely to cause air to enter the victim's stomach (gastric inflation) during bag-mask ventilation? - correct answer Ventilating too quickly What is the maximum interval for pausing chest compressions? - correct answer 10 seconds You arrive on scene to find CPR in progress. Nursing staff report the patient was recovering from a pulmonary embolism and suddenly collapsed. Two shocks have been delivered, and an IV has been initiated. What do you administer now? - correct answer Epinephrine 1 mg IV Your patient is not responsive and is not breathing. You can palpate a carotid pulse. What action do you take next? - correct answer Start rescue breathing You are the code team leader and arrive to find a patient with CPR in progress. On the next rhythm check, you see the rhythm shown here (normal sinus rhythm). Team members tell you the patient was well but reported chest discopmfort and then collapsed. She has no pulse or respirations. Bag-mask ventilations are producing visible chest rise, and IO access has been established. Which intervention would be your next action? - correct answer Epinephrine 1 mg

in Pre-Course Assessment Questions And

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Your patient is a 56-year old woman with a history of type 2 diabetes who reports feeling dizzy. She is pale and diaphoretic. Her blood pressure is 80/60 mm Hg. The cardiac monitor documents the rhythm shown here (sinus brady @ 37 bpm). She is receiving oxygen at 4L/min via nasal cannula, and an IV has been established. What do you administer next? - correct answer Atropine 0.5 mgIV (correct the rate first)