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Progressive Care question with complete solution 2023
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Pericarditis - correct answer Inflammation of the pericardium, CP that goes away w/ mvmt and relieved w/ NSAIDS; ST elevation; Sharp, stabbing CP Pericardial Effusion - correct answer Accumulation of fluid in the pericardium (the sac around the heart); complication of pericarditis; -SOB, orthopnea, tachycardia (sx of HF) -TX: NSAIDS----> Pericardiocentesis (depending on severity) Pericardiocentesis - correct answer surgical puncture to aspirate fluid from the sac surrounding the heart Cardiac Tamponade - correct answer acute compression of the heart caused by fluid accumulation in the pericardial cavity -s/sx: decreased CO, tachycardia, dyspea -ECHO -Pericardiocentesis Hallmark of tamponade: Beck's triade - correct answer Muffled heart sounds, Distended jugular neck veins, hypotension Carotid Endarterectomy - correct answer The surgical removal of the lining of a portion of clogged carotid artery leading to the brain. This is done to reduce the risk of a stroke caused by a disruption of blood flow to the brain. Carotid Endarterectomy RN - correct answer -Frequent neuro checks -Close BP monitoring -Airway monitoring
-Monitoring for hematoma formation IVC filter - correct answer Hemodynamically stable management for PE if anticoagulation contraindicated; recent trauma -Placed just below renal arteries Abdominal aortic aneurysm - correct answer Monitor control BP Surgery/repair Emphysema (COPD breakdown) - correct answer destruction of the alveoli, over time they become constricted and lose their ability to expand Bronchitis - correct answer Increased mucous and inflammation; narrowing of bronchi, scar damage (becomes chronic after 3 cases of acute) Pulmonary Embolism - correct answer A blood clot that breaks off from a large vein and travels to the blood vessels of the lung, causing obstruction of blood flow. Virchow's Triad - correct answer Risk factors for PE: Stasis of Blood flow (immobility), hypercoagulability, injury or damage (postop pts), CA pt's, Hemothorax - correct answer Blood in the pleural space Tx: Chest tube or IR/OR for embolization pneumothorax - correct answer air in the pleural cavity caused by a puncture of the lung or chest wall; air between lung tissue and lining -Lung can't expand -Tx: Chest tube
Cardiac output - correct answer Stroke Volume x Heart Rate Cardiac Output is - correct answer The amount of blood pumped out of the heart each minute and sent out to the body -approx. 4-8L/min Stroke Volume - correct answer The amount of blood ejected from the LV with each contraction Synchronized cardiovert - correct answer Happens when a low energy electric shock using a sensor is delivered in synchrony with the ORS wave Preload - correct answer The precontraction pressure in the heart as the volume of blood builds up.
-Is troponin raised? -Yes - Non-STEMI- heparin and cath lab -No - Unstable angina - Imdur and stress test Troponin - correct answer Released when cardiac damage onset of 4-6 hours peak in 24 duration 5 days 0.3 diagnostic