Nursing Transition and Career Advancement, Exams of Nursing

Download Nursing Transition and Career Advancement and more Exams Nursing in PDF only on Docsity! NUR 254 Test Exam 1 and Final Exam New Latest Version Best Studying Material with All Questions from Actual Past exam and Correct Answer A nurse is working hard to stay up-to-date on current practice and continuing to grow in skill and knowledge for his speciality. The nurse is not looking to advance his career, but to remain in his current position. Which of the following phases of the nursing career is this nurse most likely in? ------------ Correct Answer ----------- Harvest phase Which of the following organizations focuses on providing nurses with evidence-based practice, trends in the field, and standards of specialty practice? ------------ Correct Answer ----------- Specialty Organizations This lab value is elevated in response to inflammation ----------- Correct Answer ------------- c reactive protein (CRP) usually elevated in CAD Your pt is on a heparin drip and the lab reports that the PTT is 80, what do you do? Shut off the drip, increase it, or decrease it? ----------- Correct Answer ------------- Leave the rate the same ` Your pt is diagnosed with pulmonary embolus, what is one essential nursing intervention? -------- --- Correct Answer ------------- Anticoagulants and O2 to keep the sat over 93% Norepinephrine/Lopressor would show what ----------- Correct Answer ------------- Elevated MAP/increased blood pressure Hyperkalemia (K of 7) would show us what on a 12 lead ----------- Correct Answer ------------- peaked 12 lead Which of the following is a reason why all nurses should join the American Nurses Association? ------------ Correct Answer ----------- The American Nurses Association lobbies legislators to promote the passage of laws affecting the practice of nursing Which of the following is the most effective method of coping with the transition from student to nurse? ------------ Correct Answer ----------- Identify nurses who were able to make the transition successfully and discuss work-related issues with them Which of the following is a challenge some new nurses may face when transitioning from student to nurse? ------------ Correct Answer ----------- Employers expect new nurses to be able to provide safe care and set work priorities right from the first day Which of the following most accurately describes a current concern in health care today? --------- --- Correct Answer ----------- Gun violence has become a rising public health concern Which of the following is a benefit of the U.S. health-care system? ------------ Correct Answer --- -------- The use of technology is projected to decrease health-care costs and improve clinical outcomes Which of the following is a change enacted by the Patient Protection and Affordable Care Act? -- ---------- Correct Answer ----------- Expansion of school-based health centers Which of the following is a nursing issue of concern today? ------------ Correct Answer ----------- Safe staffing Which of the following is the best argument for lower nurse-to-patient ratio? ------------ Correct Answer ----------- Greater patient-to-nurse ratios decrease patient mortality Although there is projected to be a small surplus of nurses by 2030, some states will continue to see nursing shortages. Which of the following is the best explanation for this situation? ----------- - Correct Answer ----------- Workforce availability Which of the following is expected to most likely be true in the near future? ------------ Correct Answer ----------- Increased focus on care transitions will involve nursing A new model for health care in the future would be best to include which of the following? ------- ----- Correct Answer ----------- Care that encourages a healthy environment Which of the following best describes the public image of nurses today? ------------ Correct Answer ----------- Nurses are assistants to physicians Which of the following is the best way to improve nursing's image? ------------ Correct Answer -- --------- Take every opportunity to speak to the public about nursing Which of the following is the best way for a nurse to improve quality of care? ------------ Correct Answer ----------- Collaborate with other health-care professionals, patients, and their families Which of the following is the best action an individual nurse can take to exert leadership in supporting the profession of nursing? ------------ Correct Answer ----------- Talk about health-care issues to everyone who will listen, including legislators Which of the following is true regarding the Affordable Care Act? ------------ Correct Answer ---- ------- The Affordable Care Act attempted to address many of the issues of interest to nursing, but came with much controversy Which of the following new opportunities might a new nurse see in the future? ------------ Correct Answer ----------- Transitional Care Which of the following best describes a major concern about the health-care system in the United States? ------------ Correct Answer ----------- Quality of care What are the differences between functional, team, total patient care, and primary nursing? ------- An experienced registered nurse (RN) is reflecting over the chosen career path. The RN has recently passed the certification examination for his or her chosen speciality. Which of the following career stages is the RN most likely in? ------------ Correct Answer ----------- Momentum phase As nurses grow in their profession, it is important to have a career-building toolbox. Which of the following is a professional activity to consider for the toolbox? ------------ Correct Answer --- -------- Join a committee at work What are ways to empower nurses? ------------ Correct Answer ----------- - Decision Making: Control of nursing practice within an organization - Autonomy: Ability to act on the basis of one's knowledge and experience - Manageable Workload: Reasonable work assignments - Reward and Recognition: Appreciation, both tangible (raises, bonuses) and intangible (praise), received for a job well done - Fairness: Consistent, equitable treatment of all staff Leadership theories and how would you recognize the difference between them? ------------ Correct Answer ----------- What are key motivational factors a nurse leader should possess? ------------ Correct Answer ----- ------ What are the benefits and consequences of conflict? How can conflict resolution be a good thing? ------------ Correct Answer ----------- What are some activities a nurse can do to grow in their profession? ------------ Correct Answer -- --------- What are the 3 stages or phases of a nurse's career? ------------ Correct Answer ----------- What is a hierarchy? ------------ Correct Answer ----------- Key qualities and behaviors an effective nurse leader should have ------------ Correct Answer ---- ------- Key steps to being a better follower ------------ Correct Answer ----------- - If you discover a problem, inform your team leader or manager right away - Even better, include a suggestion for solving the problem in your report - Freely invest your interest and energy in your work - Be supportive of new ideas and new directions suggested by others - When you disagree, explain why - Listen carefully and reflect on what your leader or manager says - Continue to learn as much as you can about your speciality areas - Share what you learn How is a nurse manager different from a nurse leader? What qualities are important for a manager? ------------ Correct Answer ----------- What are the stages of change and how would you recognize them? ------------ Correct Answer -- --------- 1. Precontemplation (As far as I'm concerned, I don't have any problems that need changing, "Never") 2. Contemplation (I guess I have faults, but there's nothing that I really need to change, I've been thinking that I wanted to change something about myself, "Someday") 3. Preparation (I wish I had more ideas on how to solve my problems, I have decided to make changes in the next 2 weeks, "Soon") 4. Action (I am committed to joining a fitness club by the end of the month, Anyone can talk about changing I'm actually doing something about it, "Now") 5. Maintenance (I am doing okay, but I wish I was more consistent, This has become part of my day and I feel it when I don't follow through, "Forever) How did the Patient Protection and Affordable Care Act benefit nursing? ------------ Correct Answer ----------- What things should you consider when applying for a nursing position? ------------ Correct Answer ----------- What are key concepts to being a team player and having an effective team? ------------ Correct Answer ----------- Identify future trends in nursing ------------ Correct Answer ----------- What is important to include with your resume? ------------ Correct Answer ----------- Professional organizations and how they can advance your career ------------ Correct Answer ----- ------ What is emotional intelligence in a nurse leader? ------------ Correct Answer ----------- - Consciously address the effect of people's feelings on the team's emotional reality - Recognizes and understand his or her own emotions - Welcomes constructive criticism, asks for help when needed, can juggle multiple demands without losing focus, and can turn problems into opportunities - Listens attentively to others, recognizes unspoken concerns, acknowledges others' perspectives and brings people together in an atmosphere of respect, cooperation, collegiality, and helpfulness so they can direct their energies toward achieving the team's goals Describe power ------------ Correct Answer ----------- The actual or potential ability to recognize one's will even against the resistance of others; refers to ability Ways to prevent violence ------------ Correct Answer ----------- - Participate in or initiate regular workplace assessments - Be alert for behaviors that precede violence, such as verbal expressions of anger and frustration, threatening body language, signs of drug or alcohol use, or the presence of a weapon - Know your patients - Maintain behavior that helps to defuse anger - If you cannot defuse the situation, then remove yourself from it quickly, call security, and report the situation to management What does SWOT mean? ------------ Correct Answer ----------- Developing Strengths, Weaknesses, Opportunities, and Threats analysis What are factors that support a caring environment? ------------ Correct Answer ----------- The good and bad of EMR's ------------ Correct Answer ----------- - Advantages: track data through time; identify which patients need preventive screenings or checkups; monitor patients status regarding health maintenance and prevention, such as blood pressure readings or vaccinations; evaluate and improve the overall quality of care within the specific practice - Disadvantage: does not easily move out of the specific provider practice or health-care institution What are vital considerations when delegating? ------------ Correct Answer ----------- The RN has been assigned to care for a group of patients on an inpatient unit. The RN is assigned an LPN and an NAP to assist in caring for the group of patients. Patients are assigned to the RN and nursing team for their entire length of stay on the unit. Which of the following types of nursing does this scenario best represent? ------------ Correct Answer ----------- Dyad primary nursing An ICU RN has been assigned to a high acuity patient who needs constant assessment and evaluation. What type of nursing is this RN performing? ------------ Correct Answer ----------- Total patient care A charge nurse is faced with a unit that is short staffed. The charge nurse reviews the tasks that need to be completed and assigns them to the best person. Which of the following types of nursing does this describe? ------------ Correct Answer ----------- Functional nursing Initial dose of amiodarone bolus IV ----------- Correct Answer ------------- 300mg The med is administrated rapid iv push resulting In a brief flatline, used for SVT, code cart must be at bedside ----------- Correct Answer ------------- adenosine what are the doses for adenosine? ----------- Correct Answer ------------- 6mg, 12 mg, 12mg rapid IV push medication used PRN for angina ----------- Correct Answer ------------- Nitro- warn of HA, low BP WHAT IS THE PRIORITY INTERVENTION FOR VENTRICULAR FIBRILLATION, THAT HAS THE GREATEST IMPACT ON SURVIVAL RATE? ----------- Correct Answer ------------- defib A PATIENT DEVELOPS PSVT AND IS SYMPTOMATIC. PRIOR TO ADENOSINE OR CARDIOVERSION, WHAT IS A NONPHARMACOLOGIC INTERVENTION FOR PSVT? -- --------- Correct Answer ------------- ELICIT VAGAL RESPONSE/VALSALVA MANEUVER WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? ----------- Correct Answer ------------- EKG WHAT DIAGNOSTIC TEST IS ESSENTIAL IN THE DIAGNOSIS OF STEMI (ST ELEVATION MYOCARDIAL INFARCTION)? ----------- Correct Answer ------------- echocardiogram WHAT IS THE MOST LIKELY IMMEDIATE COMPLICATION FOLLOWING CARDIAC CATHETERIZATION SHEATH REMOVAL? ----------- Correct Answer ------------- bleeding Shock is a SYNDROME resulting from a decrease in a. ____________, that causes inadequate b. __________ resulting in ischemic organs/tissues that cannot carry out cellular metabolism. ---- ------- Correct Answer ------------- a. blood flow b. oxygenation When monitoring for effectiveness of treatment, which value is often used to titrate medications such as norepinepherine, as it is an indicator of tissue perfusion. ----------- Correct Answer ------- ------ MAP Which findings indicates progression from early (I) to intermediate (II)? 1. decreased U/O 2. increased lactic acid/ hyperkalemia 3. fluid shift from interstitial space INTO capillaries 4. MAP drop 12 mmHg ----------- Correct Answer ------------- 2. increased lactic acid/ hyperkalemia if norepinephrine, dobutamine or dopamine infiltrates in a peripheral site which medication should be used as an antidote? ----------- Correct Answer ------------- Phentolamine Four factors necessary to maintain cellular metabolism. When one of these is disrupted, shock occurs. ----------- Correct Answer ------------- 1. Cardiac output 2. Vessel diameter and tone 3. Blood volume 4. Tissues ability to extract and use O2 All of the manifestations of shock can be directly related to the body's attempts to maintain __________. ----------- Correct Answer ------------- Perfusion of vital organs (heart and brain) In stage I of shock, compensatory mechanisms begin when there is a volume loss of approximately 1000 mL which causes a MAP drop of __________ mmHg ----------- Correct Answer ------------- 10-15 mmhg A patient is involved in a MVC. Which finding would indicate neruogenic shock as opposed to hypovolvemic shock? 1. Decreased hgb and hct 2. Bradycardia 3. Tachycardia 4. Hypotension 5. Hypertension ----------- Correct Answer ------------- 2. bradycardia What test might be used to diagnose septic shock (as opposed to cardiogenic shock)? 1. lactic acid level 2. BNP 3. blood cultures 4. EKG ----------- Correct Answer ------------- blood cultures When administering norepinepherine to a patient in shock the expected outcome (goal) is often: - ---------- Correct Answer ------------- MAP > 65 or SBP > 80-100 What are the three (3) components of Virchow's Triad? ----------- Correct Answer ------------- 1. Endothelial damage (smoking, HTN) 2. Hypercoagulability (obesity, hormones) 3. Stasis (immobility, polycythemia) Which of the following is NOT a clinical manifestation of PE? Dyspnea, anxiety, tachycardia, low grade fever, syncope, ischemic chest pain. ----------- Correct Answer ------------- ischemic chest pain is not a manifestation of PE. Pleuritic chest pain is characteristic of PE A patient with a known DVT (deep vein thrombosis) may have a surgical procedure to place this, which would "catch" any clots that may dislodge ----------- Correct Answer ------------- Inferior Vena Cava (IVC) filter How will the nurse quantify the expected outcome of a heparin drip? ----------- Correct Answer -- ----------- Titrate Heparin with a partial thromboplastin time (PTT) of 2 - 3 times the baseline When taking an anticoagulant name 3 necessary interventions for "bleeding precautions"? -------- --- Correct Answer ------------- longer pressure to puncture sites No IM injections avoid tissue trauma soft bristle tooth brush electric shaver (no razors) What is the antidote for heparin? ----------- Correct Answer ------------- protamine sulfate Which nursing intervention is necessary for a patient diagnosed with PE? a. Ambulate frequently b. Administer heparin therapy c. Administer all medications intramuscularly (IM) for quicker absorption. ----------- Correct Answer ------------- b. administer heparin therapy When administering warfarin therapy what laboratory data would reflect the expected outcome? ----------- Correct Answer ------------- international Normalized Ratio (INR) between 2 to 3 (normal for warafrin) less than 1.1 in normal healthy pts What is the reversal agent for Coumadin (warfarin)? ----------- Correct Answer ------------- vitamin k The p wave signifies ----------- Correct Answer ------------- Atrial depolarization and contraction In order to measure the PR interval the nurse would place the calipers: ----------- Correct Answer ------------- At the beginning of the P wave to the beginning of the QRS complex The ST segment should be: ----------- Correct Answer ------------- on the same plane as the isoelectric line Inversion of the T wave signifies: ----------- Correct Answer ------------- Myocardial injury (NOT INFARCTION) Which of the following ECG changes signifies myocardial infarction? ----------- Correct Answer ------------- ST elevation Pathologic Q waves In order for cells to "do their work" (cellular metabolism), which of the following physiologic RRMC usually has premixed 400 mg/250 mL D5W or NS Antidote is Regitine Contraindications/Precautions-patients with pheochromocytoma or uncorrected tachyarrhythmias Nitroglycerin Vasodilator SHOCK med ----------- Correct Answer ------------- indicated for CHF, HTN, MI, ACS, CP, and angina. Dilates both arterial and venous vessels. ↑ blood flow & myocardial O2 supply. Venous dilatation allows peripheral blood pooling, reducing venous return, preload (initial stretching before contraction), and cardiac workload. RRMC pre-mixed is 50 mg/250 D5W starting at 3 mcg/min or 5 mL/hr and titrate accordingly Sublingual is the drug of choice & usually provides immediate relief for acute attacks. Review how many you can give and how often???? Checking for what in between each SL pill????? Usually given in paste form for preventative attacks. Take up to three SL tabs Q 5minutes and assess BP before each time. Also can be given IV gtt (mcg/min), SL, IC, paste, spray, and patches. Find out what medications they are on do not give w/ Viagra because of major S/E hypotension & HA. Contraindications/Precautions-patients who are allergic to organic nitrates, pericardial tamponade, restrictive cardiomyopathy, or constrictive pericarditis, or if CO dependent on venous return Nitroprusside (Nitropress) Vasodilator SHOCK med ----------- Correct Answer ------------- potent and indicated for hypertensive crisis, CHF, MI. Reduces afterload and ventricular filling pressures.Usually dilute 50 mg/250 mL D5W and IV infusion rate: 0.5 to 10 mcg/ kg/ min & titrate to BP. Must protect solution in black bag r/t photosensitivity. Can develop cyanide toxicity Other Medications for SHOCK ----------- Correct Answer ------------- Colloids (volume expanders) Crystalloids (IV fluids) Diuretics Sodium Bicarbonate- for acidosis Calcium- replaced if a lot of blood given Antiarrhythmic agents Broad spectrum antibiotics Corticosteroids Morphine cardiac S/S of compensatory/ early shock ----------- Correct Answer ------------- Adequate early stages. Heart rate increased, but BP normal. cardiac S/S of progressive/ intermediate shock ----------- Correct Answer ------------- HR >120 bpm. Vasoconstriction = thread pulses. BP drops overall with narrowing pulse pressure. Acidosis/hypoxia and hyperkalemia lead to altered conduction/dysrhythmias. respiratory S/S of compensatory/ early shock ----------- Correct Answer ------------- Tachypnea early on. respiratory S/S of progressive/ intermediate shock ----------- Correct Answer ------------- # of alveoli perfused decreases as shock progresses. Hypoxemia and respiratory acidosis. If this persists ARDS may develop. GI S/S of compensatory/ early shock ----------- Correct Answer ------------- Initially, decreased blood flow is minimal. Early liver perfusion changes may result in increased glucose levels. GI S/S of progressive/ intermediate shock ----------- Correct Answer ------------- As splanchnic circulation decreases "stress ulcers" which may hemorrhage. Also, paralytic ileus. If limitation continues may result in necrotic bowel. As liver perfusion decreases liver can't regulate glycogen and hypoglycemia. Also, can't remove lactic acid therefore more metabolic acidosis. Neuro S/S of compensatory/ early shock ----------- Correct Answer ------------- Initially, cerebral hypoxia-anxiety. neuro S/S of progressive/ intermediate shock ----------- Correct Answer ------------- As shock progresses cerebral edema and acidosis leads to lethargy&progresses to coma. Renal S/S of compensatory/ early shock ----------- Correct Answer ------------- nothing early on renal S/S of progressive/ intermediate shock ----------- Correct Answer ------------- Progressive stage blood is shunted away from kidneys to heart and brain. Decrease in U/O. Oliguria of <20 ml/hr (<30 X 2 hours warrants a call). Waste products will be elevated. May result in permanent kidney damage in older adults or chronically ill. skin, temp, thirst S/S of compensatory/ early shock ----------- Correct Answer ------------- Pale very early on. Be sure to assess lips and mucous membranes in darker skin colors. skin, temp, thirst S/S of progressive/ intermediate shock ----------- Correct Answer ------------- Cool and moist as it progresses. Will also see third spacing edema as it progresses. Decreased body temperature and increased thirst response. You are caring for a pediatric client in hypovolemic shock following a bicycle crash. The family members refuse blood, explaining that it is against their religious beliefs. How will you respond? ----------- Correct Answer ------------- As a nurse, you would educate the family on the importance of the blood, explaining that their child has lost a lot of blood, is in shock, and needs that volume replaced. If they still refuse, there are nonblood products that can be used to expand the volume, and the family probably will agree to this. What options for treatment might be considered for this child that do not conflict with the family's religious beliefs? ----------- Correct Answer ------------- Volume expanders can be used to increase the circulating volume. At times, clients who refuse blood will agree to albumin, which works well for hypovolemic shock. Contrast the administration of IV fluids for the client in hypovolemic shock versus the client in cardiogenic shock. ----------- Correct Answer ------------- With hypovolemic shock, as much fluid as possible is needed to replace volume. In cardiogenic shock, IV fluids are given cautiously so as not to overload the heart. Contrast the administration of colloids versus crystalloids in treating the client with hypovolemic shock. ----------- Correct Answer ------------- Crystalloid solutions only minimally increase fluid volume. Only a small amount stays within the vascular system. Colloid solutions do not diffuse through the capillary walls, but remain in the vascular system and therefore are good plasma volume expanders. What are the two (2) components of the cardiac output equation ----------- Correct Answer -------- ----- stroke volume HR What would INCREASE the cardiac output? ----------- Correct Answer ------------- Increased heart rate Decreased afterload Increased preload Increased contractility If the sinoatrial (SA) node is unable to pace the heart due to damage, the atrioventricular (AV) node will take over. What will the heart rate range be if this occurs? ----------- Correct Answer --- ---------- 40-60 BPM Which of the following factors INCREASE the heart rate? ----------- Correct Answer ------------- Exercise Fever Hypovolemia Standing position Hypoxia Within 1 hour of an MI which of the following complications would be most likely to occur and result in death? ----------- Correct Answer ------------- VFIB A client complains of chest pain and the nurse administers 0.4 mg of SL nitro. Prior to administering a second dose 5 minutes later, the nurse should assess which of the following? ----- ------ Correct Answer ------------- check bp reassess pain After administering nitroglycerin a patient complains of headache. The nurse knows this is: ------ ----- Correct Answer ------------- the result of vasodilation in the cerebral vessels The nurse is preparing to administer metoprolol to a patient with coronary artery disease. She notes the apical heart rate is 58. The nurse should: ----------- Correct Answer ------------- administer the medication The nurse is administering aspirin 81 mg to a patient on the cardiovascular telemetry unit. The nurse is aware the most likely rationale is: ----------- Correct Answer ------------- for the antiplatelet effect A patient is experiencing STEMI (ST elevation myocardial infarction). The nurse has administred SL nitro every 5 minutes X 3 with no relief. What analgesic will the nurse anticipate administering next? ----------- Correct Answer ------------- morphine A patient with myocardial infarction is ordered the fibrinolytic streptokinase. Which of the following would contraindicate its use? ----------- Correct Answer ------------- a patient that fell 3 days ago A patient has been receiving enoxaparin. Which of the following labs is important to monitor to detect HIT (heparin induced thrombocytopenia)? ----------- Correct Answer ------------- platelet count A patient with coronary artery disease has been taking aspirin 81 mg daily for more than a year. The physician prescribes clopidogrel after the patient has a cardiac cath with stent placement. The physician continues the aspirin order as well. The nurse should: ----------- Correct Answer -- ----------- administer the medication as it acts differently to prevent platelet aggregation than aspirin What nutritional recommendations will you teach the client with, or at risk for, CAD? ----------- Correct Answer ------------- The nurse will recommend a low-salt, low-fat, low-cholesterol diet, and, if the client is overweight, a reduction diet as well, with calories to be determined by a dietician. The nurse can also provide foods in each group that would be good for the client. What will you teach the client about physical fitness and exercise in regards to reducing the risk of CAD? ----------- Correct Answer ------------- The nurse will help the client determine which activities precipitate episodes of pain and will encourage regular moderate exercise. The client should be referred to a local cardiac rehabilitation center, if appropriate. What role does obesity play in regard to risk for CAD? Explain the physiology of this impact. ----------- Correct Answer ------------- Obesity can contribute to coronary artery disease by increased total blood volume, increased stroke volume, increased cardiac output, left ventricular hypertrophy, and increased cardiac deconditioning. What teaching would you provide the client with type 2 diabetes mellitus to reduce the risk of CAD? ----------- Correct Answer ------------- This client would be advised to check blood sugar often and keep it within normal limits, to eat a low-salt and fat-free diet to keep blood pressure down, and to keep weight within normal limits. safety teaching for a pt with afib ----------- Correct Answer ------------- The client should be told to see the doctor if he feels the palpitations because this dysrhythmia can have some complications (i.e., clotting of the pooled blood or a rapid ventricular response). Your client has an internal pacemaker in place secondary to third degree heart block. When you provide safety instructions, the client asks why battery-powered equipment is used rather than electrically powered equipment. How will you respond? ----------- Correct Answer ------------- The battery-powered equipment is safer for the client. Electrically powered equipment could deliver a shock when it is not supposed to, thereby posing a danger to the client. What information will you provide the client with supraventricular tachycardia who plans to continue smoking cigarettes? ----------- Correct Answer ------------- The client with supraventricular tachycardia has some hypoxia. The smoking will make this even worse because it constricts blood vessels. What alterations will you make to your plan of care for the client with a dysrhythmia who also abuses cocaine? ----------- Correct Answer ------------- Someone who uses cocaine is at an increased risk for cardiac problems. The nurse would educate that person on all the signs and symptoms to report, but would definitely also suggest a drug rehabilitation facility. Hopefully, when the client is off the cocaine, the dysrhythmia will improve. medications for afib ----------- Correct Answer ------------- diltiazem, amiodarone, and warfarin . . diltiazem is considered a calcium channel blocker (blocks the entry of calcium, therefore decreases the force of contraction of the heart and its rate of contraction. It also relaxes the muscles surrounding the arteries, allowing the arteries to dilate. So it is used in tx of angina, BP, and arrhythmias. Used to convert patients in Afib to NSR. The other main purpose it serves is to control HR because some of the Afib patients have a high heart rate r/t fast ventricular response. Can be given for PSVT and atrial fib/aflutter usually 20 mg IVP over 2 minutes; after 15 minutes, 0.35 mg/kg (25 mg). Then continuous infusion of 10 mg/hr IV initially; increased to no more than 15 mg/hr for up to 24 hours. Amiodarone is an antiarrhythmic that is used to treat both SVT arrhythmias and ventricular arrhythmias. The mechanism of action of Amiodarone remains unknown, but within the framework of ACLS, Amiodarone is used primarily to treat ventricular fibrillation and ventricular tachycardia that occurs during cardiac arrest and is unresponsive to shock delivery, CPR, and vasopressors. We usually give 300 mg bolus then IV gtt is started for 6 hours @ 1mg/min or 18ml/hr → then 0.5mg/min over 18 hrs or 33ml/hr. For tachycardia other than pulseless VT/VF, Amiodarone dosing is 150 mg/50 ml D5W and run over 10 minutes and should only be diluted with D5W and given with an in-line filter. Synchronized Cardioversion - For an uncontrolled rate with medicine interventions that did not work cardioversion may be appropriate. interventions for a pt in vfib ----------- Correct Answer ------------- Assess, confirm rhythm, & DEFIB! interventions for sinus tach ----------- Correct Answer ------------- assess the underlying cause to see why they are tachycardic!! Is this new? Is it caused by activity or emotional upset? Is it due to another medication? a flutter ----------- Correct Answer ------------- Verapamil, Digoxin, beta blockers, Cardioversion, anti-coagulants, & anti-arrhythmics (Cardizem) EKG ----------- Correct Answer ------------- Shows cardiac electrical activity cardiac cath ----------- Correct Answer ------------- Visualization of coronary arteries stress test ----------- Correct Answer ------------- evaluates function with exercise chest xray ----------- Correct Answer ------------- Can identify hypertrophy cardioversion ----------- Correct Answer ------------- Synchronized shock ICD ----------- Correct Answer ------------- Detects life threatening rhythms pacemaker ----------- Correct Answer ------------- Pulse generator to maintain CO angioplasty ----------- Correct Answer ------------- Restore blood flow to ischemic area Atherectomy ----------- Correct Answer ------------- shaves off plaque in vessel CABG ----------- Correct Answer ------------- Uses vein or artery to bypass vessel Atropine ----------- Correct Answer ------------- Anticholinergic-symptomatic brady