Download RCIS CCI EXAM 3: Cardiac Procedures and Interventions - Questions and Answers and more Exams Advanced Education in PDF only on Docsity!
RCIS CCI EXAM 3 QUESTION AND ANSWER
if a pt is experiencing hyperkalemia, which of the following might be seen on the 12 lead ekg - a sharply pointed T wave this is generated by the last phase or the depolarization - T wave ____ is upright in leads I, II, V3-V6 - T wave the T wave is inverted in which lead - aVR which of the following might NOT be considered a side effect of cardizem - joint pain ____ is considered a calcium channel blocker - Cardizem what are some of the side effects of cardizem - asthenia (muscle weakness) ankle edema dizziness flushing which of the following would be considered classifications of aortic dissections according to DeBakey - Type 1 (just above the AO valve and is most common) Type II (just above the AO valve but stop in the ascending AO not progressing into the AO arch) Type III (begins past the AO arch and distal to the L subclavian art) what is the great vessel that carries deoxygenated blood from the lower extremities back into the R atrium - IVC
which of the following might be considered a typical loading dose for clopidrogrel (plavix) - 150mg-600mg what kind of drug is clopidrogrel (plavix) - ADP inhibitor what is the daily dose for clopidrogrel (plavix) - 75mg which of the following devices uses a diamond dust-tipped burr that spins at 150,000-200, rpm within the art to pulverize the calcified plaque - rotablator rotational atherectomy device this device selectively ablates the nonelastic diseased tissue and the normal healthy tissue is pushed out of the way and not touched - rotablator during a cardiac cath which of the following is not done by the monitor - performs a direct assessment of the pt who would perform the direct assessment of the pt - circulating nurse the primary objective of the ___ is to monitor the pts vital signs, enter hemodynamic data, pt demographic information, and documents all pertinent data from the procedure into the database - monitor if the cardiac cath procedure is being performed on a newborn infant, which of the vessels would be considered the typical one used - umbilical using this vessel for a cath on a newborn infant allows for easy access to the arterial and the venous circulation of the pt - umbilical
visualize the cardiac structures visualize the pulmonary structures the volcano therapeutics phased array IVUS cath would have how many electronic elements that are mounted circumferentially near the distal tip of the catheter - 64 when performing a LV gram, which of the following is typically performed prior in order to establish the presence/absence of the worst-case disease scenario - coronary angiogram what would be used to confirm the placement of the intra-aortic balloon pump that is inserted at the bedside - portable chest xray when performing this, there should be at least 2 staff members present in addition to the physician. one staff member will assist the physician while the other connects the device, initiates, and monitors the pt - placing an IABP at bedside the most common congenital cardiac abnormality would be considered - atrial septal defect (ASD) what is considered the most effective treatment for ASD - surgical closure when the pt is transferred to the CCL for a PCI, which of the following would not typically need to be assessed - medication history when the pt arrives in the CCL, they should be assessed for - baseline ECG O2 sat lab values BP
if a pt is in need of temporary pacing, which would be considered the ideal choice for treatment of the emergency pt - external transcutaneous pacing this type of pacer works by delivering a timed electrical impulse to the chest wall of the pt by the use of pacing electrode patches - external transcutaneous pacer clinical evaluation for a mitral stenosis would include all of the following except - liver enzymes clinical evaluation for mitral stenosis would include - medical history in depth physical assessment transesophageal assessment (TEE) 2D echo with doppler study chest radiography if the pt has a temporary pacemaker in place, which of the following would not be considered correct - if the temporary pacing is prolonged, the transesophageal method should be considered the V wave in the PCWP would indicated which of the following - the rise in the pressure that is brought on by the filling of the L atrium with oxygenated blood from the lungs this represents the contraction of the L atrium when you are looking at a PCWP tracing - A wave this shows the relaxation of the atrium when you are looking at a PCWP tracing - x descent which of the following might be considered a cardinal symptom of mitral regurg - orthopnea paroxysmal nocturnal dyspnea
part of the rotablator advancer would include which of the following - a fiber optic tachometer cable irrigation port nitrogen gas delivery hose milliamperes would be best described as which of the following - the measure of the amount of current that is required to deliver the pacing wire to the heart muscle the mA are typically set at ____ times the threshold value which is typically ____ - 3- 2-3 mA the presence of a significant ____ wave would be indicative of a MI - Q (at least 0.04 secs in duration and 25% of the R wave amplitude provided that the R wave is 5mm) once the anticoagulant is administered in the cardiac cath lab, when should the ACT be checked
- 5 mins after the initial ACT has been checked how long after that do you recheck it - every 30 mins which of the following would not be considered correct for one of the defects of the heart and blood vessels with the metrology of fallot - Atrial stenosis what are the 4 defects of the heart and blood vessels which might occur with metrology of fallot
- there is a hole in the wall of the heart between the R and L ventricles
- the muscular wall of the RV is thicker than normal
- pulmonary stenosis
- the AO valves are enlarged and open from both ventricles
all but which of the following might be considered potential complications of an ICD procedure - hypercalcemia what are some of the potential complications that might occur during an ICD procedure - vein thrombosis MI blood loss infection hematoma air embolism cardiac tamponade stroked which of the following would be considered the most common mechanism for Vtach - reentry _____ depends on a functional circuit - reentry hen performing a transeptal cath, the R fem vein is used. once introduced, the wire is advanced into which area - SVC to measure L arterial press which of the following would be considered the lowest PSI NTG level that is acceptable to start a procedure with a rotablator system - 500 PSI when prophylactic antibiotics are ordered for the ICD pt preoperatively, when should their infusion typically be completed - approx 30 mins prior to the incision being made
early inflation late deflation late inflation of the following, which would NOT be considered a lateral lead - aVF what are the lateral leads - aVL I V V of the following, which would be considered correct for a sealant or extravascular plug that has a high failure rate in fully anticoagulated pts - subQ vasoseal what would be considered an acceptable length of time that warfarin should be held prior to the pt having a cardiac cath - 72 hrs what should the INR be prior to having a cardiac cath - 1.5 or less medications which might have an impact on the cardiac cath risks would not include - acetaminophen medications that would have an impact on the cardiac cath risks would include - insulin NSAIDs warfarin lasix
metformin ARBs Ace inhibs Sildenafil/vardenafil/tadalafil during a cardiac cath the pt develops a retroperitoneal bleed. interventions which would be appropriate for this problem would include all of the following except - administration of additional heparin interventions that would be appropriate for a pt that has developed a retroperitoneal bleed would include which of the following - transfusion surgical consultation reversal of anticoagulation CT scan observe for hypotension avoid high femoral artery punctures volume replacement if a topical agent is used with manual compression when removing cardiac sheaths, it would help to do which of the following - hasten clotting if amiodarone needs to be administered during a high risk cardiac cath, which of the following might be considered the correct dose - 300 mg rapid IV infusion (diluted in 20-30 ml of fluid) or 150 mg over 10 mins followed by an infusion rate of 1 mg/min which of the following would be considered the best description for an allens test - test done for occlusion of the ulnar or radial arteries
information regarding the CCL standards and which of the following would be considered standards mandated by OSHA - explanation as to the modes of transmission according to OSHA standards, the CCL should provide the following - 1. explanation as to the modes of transmission
- info regarding the CCL standards
- explanation of blood born diseases
- info on hep B vaccine
- info regarding the OSHA standards
- explanation of environmental controls (benefits and limitations)
- explanation as to how to report an exposure incident
- explanation of proper follow up procedure
- rational for the selection of protective equipment that is used in the CCL the narcotic antagonist for morphine would be considered which of the following - naloxone (evzio or narcan) when the operator is writing the general cath orders, which of the following is suggested - 1. the orders should be written the night before the procedure if possible
- the pts meds and the pre-meds for the procedure should be tailored to fit the specific pt
- the dosage of insulin for the pt that is on long acting insulin should be decreased by 50%
- the pt should be NPO when the registered nurse first meets the pt having the cardiac cath, which should be the first thing they should do - introduce themselves (after this the nurse should confirm the identity of the pt and then go over the policies and protocols with the pt)
the preparation of the cardiac cath room is the responsibility of which of the following people - circulator the nurse is preparing to insert a foley cath in an adult male pt. which size cath would be appropriate in most cases - 14-18F (standard length is 18 inches) all but which of the following might be considered anaphylactic reactions that might be seen if contrast medium or allergens enter a persons body - hyperglycemia what are some anaphylactic reactions - vascular incidents shock urticaria (hives) hypotension edema bradycardia bronchospams which of the following reasons would be responsible for congenital AO stenosis causing a reduction in CO - when there is stenosis of the AO valve it will place increased press overload on the L ventricle a congenital AO stenosis can result in - a reduction of CO pulmonary congestion when analyzing the pts cardiac rhythm which of the following would be considered correct for a normal rhythm - there should be a P wave before each QRS
(all of the above) if a 9F guide cath is used in the cardiac cath lab for a procedure, which of the following would be considered the correct burr of rotablator - 2.25-2.38 mm burr which size rotablator burr would you use if you have a 10F guide cath - 2.5 mm burr which size rotablator burr would you use if you have an 8F guide cath - 2.0 mm burr which size rotablator burr would you use if you have an 6F guide cath - 1.25-1.5 mm burr metrology of ballot has all of the following characteristics except - a congenital narrowing in the descending AO a congenital narrowing in the descending AO would be a characteristic of which anomaly - coarctation of the aorta with TFO ____ would be present because of the venous blood from the R ventricle flowing into the AO - cyanosis fentanyl (sublimaze) is considered to be ____ times more potent as morphine - 100 ____ is a synthetic opioid with a quicker onset, and a shorter duration of action - fentanyl (sublimaze) during a high risk cardiac cath, a pt develops stable Vtach. Which of the following would be considered correct for the initial dosage of Lidocaine that might be ordered for this pt - lidocaine 1-1.5 mg/kg IV bolus
(another medication that might be ordered would be amiodarone) how would the CO be determined - multiply HR by SV what is the normal Co range for an adult - 4-8 L/min prior to the procedure in the cardiac cath lab, which of the following might be considered the normal loading dose for plavix - 300 mg (150-600 mg orally) (75 mg daily after PCI for 30 days or up to a year) plavix is considered a ____ - ADP inhibitor which of the following might be considered an early sign of a vasovagal reaction - sneezing yawning pallor coughing nausea (all of the above) what would be the correct range for an ACT before it would be considered safe to do a PCI - 250-350 secs when the rotablator atherectomy device is being used, which of the following helps to flush the solution through the device - pressure bag
a main method for administering contrast medium during a procedure in the CCL would be considered which of the following - closed what are the 2 main methods for administering contrast medium - open closed which of the following would be seen in a pts labs that would indicate coagulation abnormalities
- a bleeding time greater than 10 mins
- a platelet count of less than 80,000 mm
- a prothrombin time (PT) greater than 1.2 sec
- a partial thromboplastin time (PTT) greater than 1.2 secs (all of the above) the volume of blood that is left in the ventricle at the end of diastole is considered which of the following - preload ____ is quantified by measuring the LVEDP. bc of the fact that the LVEDP and the PCWP approximately equilibrates, the PCWP is often used to quantify this - preload if the cardiac cat pt is experiencing pulseless Vtach which of the following would be appropriate for sequential defibrillation - 200J 200J-300J 360J the mean press and which of the following would be considered correct for the pressures that are considered the most important with the PAWP - peak if the V wave
what are the 2 pressures that are considered to be the most important with the PAWP - peak of the V wave mean press how is the mean PAWP pressure figured - by taking the point halfway between the peak of the A wave and the lowest point of the x descent in which of the following conditions could a high RVEDP be seen - endocardial fibrosis cardiac tamponade pulmonic valve insufficiency restrictive myocardial disease constrictive pericarditis which of the following statements would be considered correct regarding the CCL and how output is measured - 1. by a digital signal that is displayed on a computer screen or lines on a paper
- the press measurement system is made up of an input signal and an output signal
- the press of the pt is exerted on the blood which is transmitted through the fluid in a catheter (all of the above) of the following, which type of myocardial infarction would be marked by changes in leads V and V2 - septal where would you see changes on an EKG for an anterior MI - 1, aVL, V2-V where would you see changes on an EKG for a lateral MI - 1, aVL, V5, and V where would you see changes on an EKG for an inferiolateral MI - II, III, aVF, and V
