Telemetry Test 88 Questions with Verified Answers, Exams of Nursing

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Telemetry Test 88 Questions with Verified Answers Medications for pulselessness (asystole, Vfib, PEA): - CORRECT ANSWER Epinephrine, Amiodarone Medications for slow rhythms (sinus brady, junctional escape, idioventricular, blocks) - CORRECT ANSWER Atropine, epinephrine infusion, dopamine Medications used for fast rhythms (Afib, Aflutter, SVT, junctional tachycardia): - CORRECT ANSWER Cardizem, Amiodarone, Digoxin, Betablockers, adenosine, lidocaine, Procainamide Inherent SA node rate - CORRECT ANSWER 60-100 The normal PR interval - CORRECT ANSWER 0.12-0.20 Time frame between two heavy lines: - CORRECT ANSWER 0.20 Atrial depolarization is represented by: - CORRECT ANSWER P Wave The T wave represents: - CORRECT ANSWER Ventricular repolarization Inherent AV node rate - CORRECT ANSWER 40-60 Time frame across one small square: - CORRECT ANSWER 0.04 Ventricular depolarization is represented by: - CORRECT ANSWER QRS complex Inherent rate of the ventricles: - CORRECT ANSWER 20-40 The normal QRS complex duration is: - CORRECT ANSWER 0.10-0.12 or less than 0.12 The interval that measures all electrical activity above the ventricle is called: - CORRECT ANSWER PR interval Electrical activity traveling to a positive pole will have P, QRS, and T waves that are: - CORRECT ANSWER upright The wave representing atrial repolarization: - CORRECT ANSWER Hidden in the QRS complex Cardiac output is determined by the rate of the: - CORRECT ANSWER Ventricles The interval that measures all activity below the atria: - CORRECT ANSWER QT interval A sinus rate rhythm with a rate that varies with respirations: - CORRECT ANSWER Sinus Dysrhythmia A conditions where the PR interval is always greater than 0.20: - CORRECT ANSWER First degree AV block An irregular rhythm with no visible P's where the atria are fibrillating: - CORRECT ANSWER Atrial fibrillation A regular rhythm witha rate of 40-60 and either inverted or no visible P's, resulting from a falure of the SA node: - CORRECT ANSWER Junctional Escape A single, early ectopic beat characterized by an upright but abnormal P wave: - CORRECT ANSWER Premature Atrial contractions A typically slow, regualar rhythm where there are more P's than QRS's, and there is no relationship between P's or QRS's: - CORRECT ANSWER Third degree heart block A type of heart block where the AV node delays each impulse slightly longer than the previous one until an impulse is blocked completely, causing "clusters" of beatings: - CORRECT ANSWER Wenckebach Asystole: definition, confirmation, interventions - CORRECT ANSWER Definition: cessation of electrical and mechanical activity of the heart Confirmation: check for pulse on patient Primary Interventions: 1) CPR 2) Treat reversible causes 3) Epinephrine Depolatization - CORRECT ANSWER the electrical activation of the cells of the heart that initiates contraction of the heart muscle, more positive value Repolarization - CORRECT ANSWER Return of the cell to resting state, negative value Polarized - CORRECT ANSWER Resting state of heart muscle Identify the path electrical impulses travel through the heart starting from the SA node - CORRECT ANSWER 1) SA node sends out the electrical impulse 2) Atria contract 3) AV node sends impulse to ventricles 4) Ventricles contract (pump) 5) SA node sends another signal to atria to contract - begins again Intrinsic rate of sinus - CORRECT ANSWER 60-100 bpm Intrinsic rate of junctional - CORRECT ANSWER 40-60 bpm Intrinsic rate of Purkinge fiber (ventricular) - CORRECT ANSWER 20-40 bpm How does AV dysfunction lead to 1st degree block? - CORRECT ANSWER Takes too long for heartbeat to travel from top to bottom of heart How does AV dysfunction lead to 2nd degree type 1 block? - CORRECT ANSWER prolongation of PR interval until an atrial impulse is completely blocked How does AV dysfunction lead to 2nd degree type 2 block? - CORRECT ANSWER infra-nodal conduction system problem, no progressive slowing How does AV dysfunction lead to 3rd degree block? - CORRECT ANSWER electrical impulse no longer travels through AV node at all Differentiate how electrical impulses travel during junctional rhythms compared to sinus rhythms - CORRECT ANSWER In a junctional rhythm, heartbeat originates from AV node or His bundle and sinus rhythm originates from SA node Premature beat - CORRECT ANSWER Spontaneous electrical discharges of the ventricles Escape beat - CORRECT ANSWER more broad; impulse can not travel quickly via normal electrical conduction system Which arrhythmia poses the highest risk of thrombus formation? - CORRECT ANSWER Atrial fibrillation Interventions for rhythms that are too slow and the patient is not tolerating will be treated with... - CORRECT ANSWER Atropine and pacemaker 2 types of capture - CORRECT ANSWER Atrial and ventricular Pacemaker wave morphology - CORRECT ANSWER Pacer spikes followed by P wave or QRS wave What kind of complications may occur with a pacemaker? - CORRECT ANSWER DVT, lead displacement, pacemaker dysfunction (failure to sense and failure to capture), infection Know 5 lead placement - CORRECT ANSWER RA - 2nd intercostal R mid clavicular line, below clavicle LA - 2nd intercostal L mid clavicular line, below clavicle V - R of sternum at 4th intercostal space RL - 6th & 7th intercostal on R mid clavicular line LL - 6th & 7th intercostal on L mid clavicular line Causes of sinus tachycardia - CORRECT ANSWER Fever, anemia, hypotension, PE, MI, exercise, anxiety, dehydration, pain, shock, stimulants, caffeine, alcohol Causes of artifact - CORRECT ANSWER 1) Patient movement 2) Loose electrodes (R/T hairy chest or dried gel) 3) Muscle tremors, shivering 4) Electrical equipment in room Components of cardiac output - CORRECT ANSWER Stroke volume and heart rate Signs and symptoms of decreased cardiac output - CORRECT ANSWER Abnormal presence of S3 & S4, angina, anxiety, hypotension, tachycardia, bradycardia, fatigue, change in LOC, crackles Why is cardiac output decreased in bradycardia? - CORRECT ANSWER Decreased filling time to decrease stroke volume - decreases CO Why is cardiac output decreased in tachycardia? - CORRECT ANSWER Reduces stroke volume because of decreased ventricular filling time, decreased preload What is the contributing concern in tachycardia beside beside the decrease cardiac output? - CORRECT ANSWER Heart failure Three treatments for SVT - CORRECT ANSWER 1) Vagal stimulation or Valsalva manuever 2) Adenosine 3) Unstable - cardioversion Which coronary artery supplies blood to a majority of the conduction system? - CORRECT ANSWER R coronary artery EKG changes with cardiac ischemia - CORRECT ANSWER ST segment deviates, T wave inversion EKG changes with cardiac infarction - CORRECT ANSWER large peaked T waves, ST elevation