Cardiac and Respiratory Emergencies: A Comprehensive Guide, Exams of Nursing

Download Cardiac and Respiratory Emergencies: A Comprehensive Guide and more Exams Nursing in PDF only on Docsity! AEMT NREMT  EXAM 2024/2025 WITH 100% ACCURATE SOLUTIONS Compression/ Ventilation ratio for one rescuer? Two? - Precise Answer ✔✔1 rescuer = 30:2 2 rescuers = 30:2 Pediatric 2 rescuer is 15:2 but otherwise stays the same What is the proper compression rate in CPR? - Precise Answer ✔✔100- 120 per minute Compression rate for: Adults Children? Infants: - Precise Answer ✔✔Adults: 2 inches Children: 1/3 depth of chest or 2 in Infants: 1.5 inches What are 2 rhythms are considered "shockable" rhythms? - Precise Answer ✔✔Ventricular Fibrilation Pulseless Ventricular Tachycardia Use the following terms to describe the flow of blood throughout the body: Atrium, Ventricle, arteries, veins, aorta, pulmonary artery, pulmonary vein, capillaries, vena cava, arterioles. - Precise Answer ✔✔1. Deoxygenated blood travels through the superior and inferior vena cava to the right atrium 2. The blood is pumped by the right ventricle to the pulmonary artery to the lungs. This is where the blood is oxygenated before being sent back through pulmonary veins to the left atrium. 3. Blood flows into the left ventricle, which is responsible for pumping blood into the aorta and out through arteries to the body. 4. Arteries branch off into arterioles, then to capillaries, which is where nutrient exchange occurs with cells. 5. Last, blood flows back into the veins, into the superior and inferior vena cava before returning to the heart. What are two important roles of red blood cells? - Precise Answer ✔✔Transport oxygen to the cells Transport carbon dioxide to the lungs 7 signs of cardiac comporomise - Precise Answer ✔✔1. abnormal blood pressure 2. pain, pressure, or discomfort in the chest or abdomen 3. shortness of breath 4. palpitations 5. anxiety or irritability 6. abnormal pulse 7. Sudden onset of nausea or vomiting The atria and ventricles are completely dissociated. -impulse is generated in the SA node in the atrium does not propagate into the ventricles. because the impulse is blocked, an accessory pacemaker in the lower chambers will typically activate the ventricles. -explains why two distinct rhythms can be noted in this heart block. In junctional rhythms, P waves can be: - Precise Answer ✔✔Hidden or inverted. -JRs originate in the lower heart, meaning the complexes will be wide, which hides the P waves, or it can invert them depending on how low in the heart they are coming from. In Normal Sinus Rhythm, P-R interval must fall between - Precise Answer ✔✔.12-.20 seconds. The P-wave is representative of what cardiac event? - Precise Answer ✔✔Atrial Depolarization The morphology of multifocal PVC's have: - Precise Answer ✔✔a variety of configurations. Multifocal PVC's have a variety of configurations due to the fact that the spot of origination moves. It's never in the same spot causing a variety of different looking waves and morphology Every little box on a 12-lead EKG is representative of how many seconds of recording? - Precise Answer ✔✔.04 seconds PVC's that appear in every third beat are referred to as: - Precise Answer ✔✔Trigenmeny. Just as Bigeminy PVCs in every two beats, Trigeminy PVCs regularly appear in every third beat. The morphology associated with unifocal PVC's have: - Precise Answer ✔✔Unifocal PVC's have constant configuration because they originate from the same spot every time- wherever the pacemaker may be. No change in morphology. Your patient is a 23-year-old college student. He states that he has had an intermittent fluttering sensation in his chest since this morning. He further states that he was up all night cramming for his final exams today. When asked if the patient had taken anything, he replies that throughout the night he had consumed about 4 large energy drinks, had some "No-Doz" anti-sleep medication and a few cups of coffee. The patient is most likely exhibiting PVC's, which are: - Precise Answer ✔✔Single irritable beats A premature ventricular contraction (PVC) is a single irritable beat. Every big box on a 12-lead EKG is representative of how many seconds of recording? - Precise Answer ✔✔.2 seconds. A basic rule for ventricular arrhythmia's is that the QRS measurement will be: - Precise Answer ✔✔.12 seconds or greater Ventricular rhythms are wide in complex, thus signifying where it originates from, with a .12 seconds or greater measurement On an EKG, Supraventricular Tachycardia can be identified by - Precise Answer ✔✔an absent p-wave with a very high rate ECG paper on a normal EKG will move at which rate of speed? - Precise Answer ✔✔25mm/sec You respond to a nursing home to find a 90-year-old male complaining of chest pain and shortness of breath. The nurse tells you that the patient has an extensive cardiac history, but she cannot find his chart to explain the exact history. You take his vital signs and find that he is tachycardic with a blood pressure of 100/50 and a pulse oximetry of 97%. You place him on a cardiac monitor and find the following rhythm which you identify as - Precise Answer ✔✔Atrial fibrilation. A patients EKG shows a rhythm at a rate of 42 beats per minute, regular RR intervals, a PR interval of .16 seconds, and a QRS of .12 seconds. This best fits the criteria for: - Precise Answer ✔✔Sinus bradycardia Due to the patient's COPD, he has inadequate gas exchange in the lungs. This causes his pCO2 to increase above 45 mmHg and pH to drop below 7.35. cardiac tamponade - Precise Answer ✔✔ An inotropic effect refers to one that effects the heart's? - Precise Answer ✔✔rhythm ino refers to muscles You are on scene at the local health club with a 42-year-old accountant who was working out after work. Bystanders report that the patient had been running on the treadmill for an hour when he "passed out" and hit his head as he fell off the treadmill. The patient has a weak, rapid pulse and has hot, dry skin. A manual blood pressure reads 70/P. What component of stroke volume is most likely the cause of the patient's condition? - Precise Answer ✔✔Decreased preload. Preload is the amount of returning blood that puts pressue against the walls of the ventricles just before they contract. Factors that affect preload are circulating blood volume, volume of blood returning to the heart, and strength of atrial contraction. The patient is dehydrated and hypotensive. This should clue you into a problem with preload Which cranial nerve is responsible for pupil size, shape, and reactivity? - Precise Answer ✔✔Oculomotor (III) Prinzmetal angina ( variant angina ) - Precise Answer ✔✔Type of unstable angina in which a coronary artery spasm is the cause for diminished blood flow. Like unstable angina, onset cannot be predicted Most classic features of MI - Precise Answer ✔✔Dull chest pain radiating typically to the left shoulder, neck, jaw, or back Difference between myocardial infarction and myocardial ischemia - Precise Answer ✔✔Infarction is death of the tissue, at the end of ischemia. Result of absence of blood supply to the heart Ischemia is decrease in blood supply to the heart leading to chest pain or angina Signs of Right-Sided Heart Failure - Precise Answer ✔✔Results in congestion of blood in vena cava Jugular venous distention Peripheral edema Enlarged liver Probably hypotension Signs of Left-Sided Heart Failure - Precise Answer ✔✔Congestion of blood in lungs Respiratory distress Pulmonary edema Lung sounds crackles or cardiac asthma Le Fort II fracture - Precise Answer ✔✔Term used to describe fractures to the face including the maxillary and nasal bones. Usually by blunt force Dose for epinephrine - Precise Answer ✔✔.3-.5mg for adults .01mg/kg for pediatric Classic symptom of subarachnoid hemorrhage - Precise Answer ✔✔Thunderclap headache Your patient responds to your commands, is oriented and converses, and localizes pain. What is his GCS and give each score - Precise Answer ✔✔Total GCS is 13. 3 for verbal command, 5 for oriented and converses, 5 for oriented and converses. subdural hematoma - Precise Answer ✔✔Collection of blood over the surface of the brain between the dura mater and arachnoid meninges What stage of contraction is blood delivered to the arteries? - Precise Answer ✔✔Diastole. The rest of the body is perfused during systole pulsus paradoxus - Precise Answer ✔✔abnormal decrease in systolic pressure during inspiration. Due to decreased cardiac output. Usually more than 10mmhg for synchronized cardioversion. Often, vagal maneuvers are able to slow the heart rate and correct the problem, before resorting to the more invasive Adenosine. Bundle of His has an intrinsic firing rate of approximately how many bpm - Precise Answer ✔✔20-40 What is the intrinsic rate for impulses originating in the atria? - Precise Answer ✔✔60bpm symptoms is most consistent with a patient presenting with new onset atrial fibrillation - Precise Answer ✔✔Atrial fibrillation is a heart rhythm that does not adequately perfuse the body with blood due to abnormal electrical impulses in the atria, leading to a usually rapid and irregular heart rhythm. During A-fib, the atria fire at approximately 400- 600 beats per minute. Hypotension is common due to the inefficiency in contractions of the heart. Altered LOC is commonly seen with A-fib due to lack of adequate blood flow, specifically to the brain In short, Tachycardia, Hypotension, and altered LOC Bell's Palsy - Precise Answer ✔✔condition that affects the 7th cranial nerve and causes facial paralysis. This condition can mimic the signs/symptoms of a stroke or CVA. What do the 4 sections of an NFPA placard represent? - Precise Answer ✔✔Blue- Health Hazard Red- Fire Hazard Yellow- Reactivity White- Specific agents ex: Corrosive, acid, or oxidizer 0= normal - 4 = very volatile Tool on ambulances to help identify hazardous substances? - Precise Answer ✔✔ERG- Emergency resource guidebook NIMS - Precise Answer ✔✔National Incident Management System Command, finance, logistics, planning, operations Asthma - Precise Answer ✔✔Chronic inflammatory disorder of the airways. Increased sensitivity of the lower airways to irritants and allergens. This causes bronchospasm and inflammation to the lining of the bronchioles Acute bronchitis - Precise Answer ✔✔Bronchial tubes become inflamed, sputum production can increase creating a productive cough. chronic bronchitis - Precise Answer ✔✔Related to COPD. Inflammation, swelling, and thickening of the lining of the bronchi and bronchioles. Thick mucus restricts airflow to alveoli so they don't expand fully causing respiratory distress. bronchiolitis - Precise Answer ✔✔Diagnosis given to young PT's who have acute onset of lower and upper airway inflammation. Disturbs V/Q ratio and causes labored breathing pneumothorax - Precise Answer ✔✔air in the pleural cavity caused by a puncture of the lung or chest wall. Causes resp. distress. Open pneumo comes from outside, closed comes from air escaping a hole in the lung into the pleural space tension pneumothorax - Precise Answer ✔✔condition in which air entrapped in the pleural space puts pressure on the lung and heart. cystic fibrosis - Precise Answer ✔✔Commonly causes pulmonary dysfunction due to changes of mucus secreting glands. Mucus lining all over respiratory tree is normally watery and warm. Abnormal gene causes an overabundance of mucus that's very thick and sticky. As this thick layer develops, blockage of airways occurs with increase of infections that can readily grow in thick mucus. Repeated infections cause scarring of lung tissue. Resp. function diminishes as ability to clear thick mucus is decreased which leads to pulmonary failure and death. tension pneumothorax - Precise Answer ✔✔ spontaneous pneumothorax - Precise Answer ✔✔