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368 Cards in this Set
- Front
- Back
CVD
|
cardiovascular disease
|
|
CVD is the cause of __% of all US deaths
|
37%
|
|
the avg heart weighs
|
250-300g
|
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apical thrust is also known as
|
point of maximal impulse (PMI)
|
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Apical thrust may be seen where
|
left anterior chest, midclavicular line, fifth intercostal space
|
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the heart is contained in a fibrous sac called the
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pericardium
|
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the pericardial sac contains about __ml of fluid
|
30ml
|
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the wall of the heart consist of how many layers
|
3
|
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name the outer layer of the heart wall
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epicardium
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name the middle layer of the heart wall
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endocardium
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the innermost layer of the wall of the heart
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myocardium
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oxygenated blood reaches the heart via the ___ artery
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coronary artery
|
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how many main coronary arteries are there
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2
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the coronary arteries branch off at the____ and just above the ____
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coronary ostia , leaflets of the aortic valve
|
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the left main coronary artery branches into the ___ and ___
arteries |
left anterior descending and circumflex arteries
|
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the left coronary artery and its branches supply blood to what parts of the heart
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L ventricle, interventricular septum, and part of the right ventricle
|
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the right coronary artery supplies what parts of the heart
|
right atrium, right ventricle, and part of the left ventricle
|
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the numerous anastomoses between the arterioles of the heart allow what to take place
|
allows the development of alternative routes in case of blockage
|
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when the anastomoses of the coronary arteries allow an alternative route after a blockage this is known as
|
collateral circulation
|
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the arteries and main vein of the heart cross the heart in a groove known as the
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coronary sulcus
|
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venous blood from the heart empties into the
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coronary sinus
|
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a large vein in the posterior portion of the coronary sulcus which ends in the right atrium of the heart
|
coronary sinus
|
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the upper chambers of the heart
|
atria
|
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the lower chambers of the heart
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ventricles
|
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the atria and the ventricles are seperated by the ____ valves
|
atrioventricular valves
|
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valve that seperates right atrium from R ventricle
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tricuspid valve
|
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valve that seperates the right atrium and ventricle
|
tricuspid valve
|
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the bicuspid valve is also known as
|
mitral valve
|
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guide wires attached to heart valves to keep them from inverting
|
chordae tendieae
|
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the chordae tendoneae attach to the ___ muscle
|
papillary
|
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valves that seperate ventricles from the pulmonary and systemic circulation
|
semilunar valves
|
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valve that seperates the r ventricle from the pulmoary artery
|
pulmonic valve
|
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valve that seperates the l ventricle from the systemic circulation
|
aortic valve
|
|
the name for the two normal heart sounds and the name for the two abnormal heart sounds
|
normal S1,S2 abnormal S3, S4
|
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first heart sound heard or S1 is the sound of what happening
|
AV valves closing
|
|
The S2 heart sound is the sound of what taking place
|
aortic and pulmonic valves closing
|
|
____ comprises one complete phase of atrial and ventrical relaxation followed by one atrial and ventricular contraction
|
cardiac cycle
|
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appoximately 80% of ventricular filling is accomplished how
|
by gravity
|
|
the contribution of ventricular filling caused by the contraction of the atria is kown as
|
atrial kick
|
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when do the AV valves snap shut
|
at the beginning of ventricular contraction
|
|
amount of time it takes to fill L atria with blood
|
0.52 seconds
|
|
amount of time ventricular contraction or systole last
|
0.28seconds
|
|
the left and right half of the heart is seperated by the
|
interventricular septum
|
|
Made up of all blood vessels from the L ventricle to the R atrium
|
systemic circulation
|
|
made up of all blood vessels from the R ventricle to the L atria
|
pulmonary circulation
|
|
Dyspnea, frothy sputum, crackles dx
|
pulmonary edema
|
|
how many layer make up the wall of an artery
|
3 layers
|
|
innermost wall of an artery
|
tunica intima
|
|
middle layer of arterial wall
|
tunica media
|
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outermost layer of arterial wall
|
tunica adventitia
|
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pressure exerted by blood on the arterial walls
|
blood preesure
|
|
only vein that carries oxygenated blood
|
pulmonary vein
|
|
only artery that carries deoxygenated blood
|
pulmonary artery
|
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the amount of blood pumped out by either ventricle measure in ml/min
|
Cardiac output
|
|
the amount of blood pumped out by either ventricle in a single contraction
|
stroke volume
|
|
avg CO of adult
|
5-6ml/min
|
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avg SV of adult
|
60-100ml
|
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the number of contractions per minute
|
heart rate
|
|
frank starlin mechanim states that when the heart_______
|
is stretched it contracts with greater force
|
|
the pressure under which the ventricle fills is called
|
preload
|
|
the ability of the heart to increase or decrease its degree of contraction
|
contractility
|
|
a positive chronotropic effect does what
|
increases heart rate
|
|
dominant pacemaker
|
SA node
|
|
SA node is an abbreveation for
|
sinoatrial node
|
|
from where does the SA node recieve its blood supply
|
right coronary artery
|
|
how long does it take for the elec. impulse from the SA node to spread across the 2 atria
|
0.08seconds
|
|
AV junction includes what structures
|
AV node , bundle of his ,
|
|
in 85-90% of the population the AV nodes blood supply comes from the
|
right coronary artery
|
|
10-15% of the populations AV node recieves blood from the
|
circumflex artery
|
|
conduction of the SA node electrical impulse is delayed in the AV node for about ____
|
0.12s
|
|
After elec. impulses leave the AV node the travel through the _____ to the ___ & ___
|
bundle of his then to the R and L bundle branches
|
|
the elec impulse from the SA node travels to where when it leaves the R&L bundle branches
|
purkinje fibers
|
|
how long does it take for the electrcal impulse to travel across the ventricles
|
0.08s
|
|
the process by which muscle fibers are stimulated to contract
|
depolarization
|
|
resting cell has a normal charge of about
|
-90mv
|
|
____ helps maintain the depolarized state of cardiac muscle tissue and suppiles ____ for use in the contraction of muscle tissue
|
calcium ions , calcium Ions
|
|
the Na+/K+ pump moves 3 __ ions for every 2 __ ions
|
3sodium for every 2 potassium
|
|
electrolyte imbalance that causes increased mocardial irritability
|
hypokalemia
|
|
hyperkalemia causes
|
decreased automaticity/conduction
|
|
causes decreased contractility and increased myocardial irritability
|
hypocalcemia
|
|
causes increased contractility
|
hypercalcemia
|
|
hypomagnesemia causes
|
decreased conduction
|
|
hyper magnesia causes increased
|
myocardial irritability
|
|
SA node rate
|
60-100
|
|
Av node rate
|
40-60
|
|
purkinje rate
|
20-40
|
|
period when the heart muscle is partially charged , but not enough to create a full contraction
|
relative refractory period
|
|
P wave represents
|
depolarization of the atria
|
|
P-R interval
|
time from the beginning of the P wave to beginnng of the
QRS complex |
|
pause between P wave and QRS is created by
|
coduction being slowed through the AV junction
|
|
QRS complex represents
|
depolarization of the ventricles
|
|
normal amount of time for PR interval or PRI
|
0.12-0.20s or 3-5 boxes on the ecg paper
|
|
T wave represents
|
repolarizatin of the ventricles
|
|
the beginning of the T wave is referred to as
|
the J point
|
|
baseline on ecg strip is called the
|
isoelectric line
|
|
an elevated or depressed ST segement may indicate
|
myocardial ischemia
|
|
time between two succesive QRS complexes
|
R-R interval
|
|
parasympathetic nervous system sends messages mainly through the
|
vagus nerve
|
|
cholinergic also known as
|
parasympathetic
|
|
Adrenergic also known as
|
sympathetic
|
|
parasympathetic blocking drugs
|
atropine
|
|
the only drug we will use that acts directly on the parasympathetic nervous system
|
atropine
|
|
Epi is also known as
|
adrenalin
|
|
alpha drugs effect on arteries
|
vasoconstriction
|
|
beta drugs effect on arteries
|
vasodilation
|
|
alpha drugs can have what effect on the lungs
|
minor bronchoconstriction
|
|
beta drugs have what effect on the lungs
|
bronchodilation
|
|
isoproterenol is a pure
|
beta agent
|
|
phenylephrine ( neo-synephrine ) is a pure
|
alpha agent
|
|
neo-synephrine has what effect
|
vaso-constriction
|
|
isoetharine and terbutaline are
|
bronchodilators
|
|
isoproternal has what effects on the body
|
increase HR, dilates bronchioles, used in extreme asthma cases
|
|
nor-epi has what effect and is used for what
|
vasoconstriction, used when hypotension is caused by vasodilation( such as neurogenic shock)
|
|
propranolol has what effect and use
|
slows HR, used to decrease the work load of heart and decrease pain of chronic angina
|
|
the pressure (resistance) in which the ventricle contracts
|
afterload
|
|
high afterloads can be caused by
|
arteriosclerosis
|
|
_____ may be the first clue to L sided heart failure
|
dyspnea
|
|
acute episode of SOB in which pt suddenly awakens with a feeling of suffication
|
paroxysmal nocturnal dyspnea (PND)
|
|
paroxysmal nocturnal dyspnea(PND) is classic sign of
|
L sided heart failure
|
|
when dyspnea worsens when a pt lies down
|
orthopnea
|
|
_______ occurs when Co suddenly declines leading to a reduction of cerebral perfusion
|
syncope
|
|
sensation of an abnormally fast or irregular heart beat
|
palpitations
|
|
blood pressure drop of 10mm/Hg
with each inspired breath |
pulsus paradox
|
|
when pulse alternates in strength from one pulse to another
|
pulsus alterans
|
|
pt's with systolic pressure from 120-139 or diastolic from80-89 are considered
|
prehypertensive
|
|
systolic pressure less than 90 may indicate
|
severe hypotension
|
|
the cold sweaty skin of MI pt reflects massive ___ __
|
peripheral dilation
|
|
JVD indicates what type of heart failure
|
R sided
|
|
AICD
|
automated implanted cardioverter defibrillator
|
|
____ is when a muscle is deprived of oxygen
|
ischemia
|
|
CAD
|
coronary artery dieease
|
|
when heart muscle has been ischemic long enough to die this is called an
|
infarct
|
|
narrowing of the arteries from fatty deposits
|
artherosclerosis
|
|
a hardening of the arteries
|
arteriosclerosis
|
|
swishing sound heard over the carotid artery that containdicate carotid sinus massage
|
bruits
|
|
swelling and pain along veins that can lead to blood clots
|
phlebitits
|
|
PE cause aprroximately ___ deaths per yr
|
200,000
|
|
ACS
|
acute coronary syndrome
|
|
term used to describe any group of symptoms consistent with myocardial ischemia
|
ACD: acute coronary syndrome
|
|
Acute myocardial ischemia usually presents as
|
chest pain
|
|
Q wave MI equals
|
heart attack
|
|
STEMI
|
ST elevation myocardial infarction
|
|
pt with chest pain and no ST segment elevation are having
|
unstable angina
|
|
the principal symptom of CAD
|
angina pectoris
|
|
the majority of MI's involve the
|
left ventricle
|
|
what is the leading cause of death in america
|
AMI
|
|
Levine sign
|
when a pt unconsciously clenches a fist when describing ches pain
|
|
___to__ of pt's with an AMI will not have chest pain
|
10-20%
|
|
name 3 types of pt's not likely to have chest pain when having an MI
|
diabetics, heart transplant, older people
|
|
Symptoms for a women having an MI
|
nausea, light headedness, epigastric burning, sudden onset of weakness, unexplained tiredness
|
|
___ is a light sensitive medication and must be stored in a dark airtight container
|
nitro
|
|
MONA
|
morphine, oxygen, nitro, ASA
|
|
if a pt is experiencing an AMI and not just angina Nitro is likely to have what effect on the pt's pain
|
none
|
|
If nitro does not releive pain give morphine at what doses
|
2-4mg IV titrated
|
|
After giving morphine what should be done if the pt starts having bradycardia
|
notify medical control immediately
|
|
side effect of morphine
|
drops blood pressure
|
|
Alternative drug for pain relief when nitro is ineffective and you can not or do not want to use morphine
|
fentanyl
|
|
VOMIT
|
vitals, oxygen, monitor, IV, transport
|
|
the majority of AMI's are the result of
|
a thrombus
|
|
fibrinolytic treatment given within __ of the onset of sympyoms can sometimes abort the AMI altogether
|
30-60minutes
|
|
activase, streptase, and retavease are all types of ___
|
fibrinolytics
|
|
____ heart failure will result in pulmonary edema
|
left sided
|
|
signs and symptoms of left sided heart failure
|
restlessness, agitation, severe dyspnea, tachypnea, tachycardia, elevated BP, crackles, frothy pink sputum
|
|
how should oxygen be delivered to pt with r sided heart failure, suffering from pulmonry edema
|
BVM, positive pressure will help drive fluid from lungs
|
|
how should pt with r sided heart failure and pulmonary edema be positined
|
sitting up with feet dangling
|
|
drug treatment for R sided heart failure with pulmonary edema with wheezing :
|
Nitro0.4mg SQ. lasix0.5-1.0mg/kg,morphine3mg SIVP, Albeuterol & atrovent if wheezing is present
|
|
What drug may be given to pt in R sided heart failure to maintain BP if transport time is long
|
dopamine
|
|
Most common cause of R sided heart failure
|
L sided heart failure
|
|
swelling of the liver
|
hepatomegaly
|
|
treatment for R sided heart failure
|
make pt comfortable
|
|
signs of R sided heart failure
|
vein engorgemant, JVD, edema
|
|
occurs when excessive fluid build up in the pericardium
|
cardiac tampomade
|
|
classic symptom of cardiac tamponade
|
narrowing pulse pressure
|
|
signs of cardiac tamponade
|
narrowing pulse pressure, hypotension,JVD, muffled heart sounds
|
|
becks triad
|
narrowing pulse pressure, JVD, muffled heart ounds
|
|
Becks triad indicates
|
cardiac tamponade
|
|
alternating small-and large amplitude QRS complexes
|
electrical alterans
|
|
changes in blood pressure can only be recognized after ___ blood pressures have been taken
|
Three
|
|
how can you tell cardiac tamponade fron tension pneumothorax
|
breath sounds will be equal and trachea will be midline in cardiac tamponade
|
|
ultimate treatment for cardiac tamponade
|
percardiocentesis
|
|
If percardiocentesis is not allowed alternative treatment for cardiac tamponade
|
rapid transport
|
|
when __% of L ventricle has been infarcted cardiogenic shock develops
|
40%
|
|
signs of cardiogenic shock
|
pale cold skin, anuria, rapid shallow respirations, thready tachy pulse, possible hypotension
|
|
treatment for cardiogenic shock
|
100% oxygen, supine, IV, 100-200ml fluid bolus, dopamine,
|
|
dopamine dose for cardiogenic shock
|
5mcg/kg/min, slowing infusion if blood pressure reaches 90-100mm/Hg and increasing infusion if pressure drops to 70mm/Hg
|
|
to prepare a dopamine infusion add ___mg of dopamine to a __ bag of NS
|
400mg dopamine to a 250ml bag of NS
|
|
greek word meaning widening
|
aneurysm
|
|
65% of all aneurysm occur
|
ascending aorta just distal to the aortic valve
|
|
if aortic dissection extends back into the aortic valve it may cause
|
the valve to be unable to close
|
|
most common chief complaint with acute dissecting aortic aneurysm
|
chest pain ( worst ever) sharp, tearing ripping, like a knife
|
|
pain from dissecting aortic aneurysm comes on ___ and is usually felt where
|
suddenly, and felt anterior chest or between the shoulder blades
|
|
how to tell the difference between pt with aneurysm or AMI
|
Aneurysm, shrp pain sudden onset, AMI preceeded by heartburn,weakness, sweating, pain is pressure, tends to come on gradually
|
|
you can tell that an aneurysm is in the innominate artery how?
|
different blood pressure in each arm
|
|
death from ascending aortic rupture is usually result of
|
cardiac tamponade
|
|
treatment for aortic aneurysm
|
calm pt, 100% O2, IV NS, If pt not hypotensive morphine 2mg q 10-15 min max 10mg
|
|
symptoms of AAA
|
abdominal or back pain in the umbilicus or lower back areas, cannot be relieved by changing position, radiates to thigh or groin, feels need to defecate
|
|
Sign of AAA
|
pulsating mass palpable in the abdomen
|
|
treatment for AAA
|
Large bore IV, fluids, O2, if signs of shock treat as shock
|
|
swishing sound over carotid artery
|
bruit
|
|
calve pain that can lead to a painful limp
|
claudication
|
|
presence of claudication indicates signifigant
|
peripheral artery constriction
|
|
STEMI
|
ST elevated myocardial infarct
|
|
UA/STEMI
|
unstable angina/ non ST segment elevated myocardial infarct
|
|
Type of angina that follows a recurent pattern
|
stable angina
|
|
occurs when a portion of cardiac muscle is deprived of coronary blood flow long enough to cause necrosis
|
AMI
|
|
The majority of AMI's involve what part of the heart
|
left ventricle
|
|
Most AMI's that involve the L ventricle are the result of ocllusion of the___ artery or one of its branches
|
L coronary artery
|
|
the SA node pace at a rae of
|
60-100
|
|
the AV junction paces at a rate of
|
40-60
|
|
The purkinje pace at a rate of
|
20-40
|
|
the P wave represents
|
the depolarization of the atria
|
|
the PR interval represents
|
the depolarization of the atria and delay of the AV junction
|
|
The QRS complex represents the
|
depolarization of the ventricles
|
|
ST segment represents
|
period of time between ventriular depolarization and beginning of repolarization
|
|
period of time between ventriular depolarization and beginning of repolarization
|
ST segment represents
|
|
treatment algorithm for asthma
|
O2, IV, Albeuterol, atrovent, Morphine, bicarbonate, MAG
|
|
treatment algorithm for Left heart failure
|
O2, IV, MONA, Pacing
|
|
QRS complex represents
|
depolarization of the ventricles
|
|
T-wave represents
|
repolarization of the ventricles
|
|
R-R interval represents
|
Time between two ventricular depolarizations, one cardiac cycle
|
|
A pure beta agent
|
phenylephrine
|
|
phenylephrine is a pure ____
|
beta agent
|
|
Nor-epi is AKA
|
levophed
|
|
of all deaths due to AMI ___% are due to arrythmias
|
90%
|
|
chest pain from angina AMI may last how long compared to chest pain from Angina
|
more than 15 minutes vs angina which will subside in smaller amount of time
|
|
in __% of AMI's pain will radiate into the arms
|
25%
|
|
women complaining of one or all of the following may be having ___: nausea, light headedness, heartburn, sudden onset of weakness, unexplained tiredness
|
AMI
|
|
____ may help to limit ischemic myocardial injury & reduce the amount of ST segment elevation
|
oxygen
|
|
phosodiesterase 5 AKA PDE-5 are what typr of drug
|
used to treat ED
|
|
pt is having AMI dose for morphine
|
2-4mg PRN
|
|
the majority of AMI's are the result of _____
|
thrombus/ blood clot usuallly in the coronary arteries
|
|
Peripheral vasoconstriction signs
|
pallor and elevated blood pressure
|
|
pallor and elevated blood pressure may indicate
|
PAD
|
|
algorithm for L sided heart failure
|
O2, BVM, pt sitting up feet dangling, IV, nitro, lasix, albeuterol, atrovent, morphine, if long transport dopamine
|
|
AVG adult dose for lasix
|
20-40g
|
|
if pt is experiencing pulmonary edema, and already taking lasix, what is the proper dose
|
twice pt's normal dose
|
|
morphine dose for L sided heart failure
|
3mg if pt is not hypotensive
|
|
systemic venous distention most obvious sign
|
JVD
|
|
JVD most likely caused by __ sided heart failure
|
Right-
|
|
pitting edema usually caused by ___ heart failure
|
Right side
|
|
goal in the treatment of cardiogenic shock
|
identify , and treat before it becomes irreversible
|
|
how can you differeniate between cardiogenic shock and hypovolemic shock
|
give a 100-200ml fluid bolus, if pt is in hypovolemic shock pulse and pressure will rise
|
|
how do you prepare a dopamine infusion
|
add 400mg to 250mlNS titrate at 5mcg/kg/min
|
|
treatment algorithm for dissecting aneurysm
|
O2, IV, monitor, morphine, rapid transport
|
|
dose of morphine for dissecting aneurysm
|
2mg q 10-15 min.: max 10mg
|
|
hypertension is BP of ___ and above
|
140/90
|
|
3 most common complications of hypertension
|
stroke, renal damage, heart failure
|
|
most common symptom directly related to hypertension
|
headache
|
|
signs and symptoms of symptomatic hypertension
|
headache weakness, epitaxis, blurred vision
|
|
bp at or above__ is considered severe hypertension
|
200/130
|
|
MAP stands for
|
mean arterial pressure
|
|
when MAP exceeds ___ the blood brain barrier is breached
|
150mm/Hg
|
|
treatment for hypertension encephalopathy is
|
lower blood pressure gradually over 30-60 minutes
|
|
drug of choice for the treatment of hypertensive encephalopathy
|
labetalol
|
|
labetalol is AKA
|
normodyne, trandate
|
|
labetalo is cotraindicated in a pt with
|
asthma, COPD
|
|
labetalol dose for hypertensive encephalopathy
|
SIVP 20 mg q 10 min PRN or drip at 250mg/250ml @ 2mg/min
|
|
drip rate for labetalol
|
2mg/min
|
|
a disturbance in the normal cardiac rythm
|
dysrrythmia/arrythmia
|
|
hypoxia, metabolic alkolosis, hypokalemia can all lead to
|
electrical instabilty
|
|
the numbers 300,150,100,75,60,50 in reference to reading an ecg allow you to do what
|
rapidily identify rates
|
|
amount of time between 2 heavy black lines on an ekg strip
|
0.2s
|
|
0.04s is equal to how many small boxes
|
1
|
|
how many leads do you attach to a pt in order to obtain a 12 lead ekg
|
10
|
|
the four limb leads are color coded. which color goes where on pt
|
white: r arm
black: L arm Red: leg Green : r leg |
|
2 chest leads that are over L side of heart or are known as L chest leads
|
v-5, v-6
|
|
2 chest leads that are over r side of heart or are known as R chest leads
|
v-1, v-2
|
|
which chest leads are over the interventricular septum
|
V-3,V-4
|
|
the response of automaticity foci in a pause in the pacemaking activity
|
escape
|
|
rythm 20-40bpm, no p waves, widened QRS
|
idioventricular or ventricular escape rythm
|
|
for a QRS to be considered widened what must the duration be
|
greater than .12s or 3 small boxes
|
|
MAT
|
multifocal atrial escape rythm
|
|
40-60BPM, no visible P wave, QRS less than .12s, rythm regular DX
|
junctional rythm
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quick way to tell the difference in a ventricular rythm and a juntional rythm
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duration of the QRS complexes
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___ automaticity foci are the worlds most sensitive O2 receptors
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ventricular
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number one cause of ventricular foci irritabilty
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lack of oxygen
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number one cause of atrial foci irritabilty
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adrenergic substances
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PAB
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premature atrial beat
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SVT
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supraventricular tachycardia
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PVC
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premature ventricular contraction
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PAC
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premature atrial contraction
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rate of 85, normal PQRST, followed by a premature but otherwise normal PQRST. pattern is continuous (2 beats normal pause, 2 beats normal pause etc) DX
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atrial bigeminy
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A rythm in which you have a pattern of two normal PQRST's and the second PQRST is always followed by a premature beat. constant and repeating ( two normal one premature , 2 normal -1 premature etc) dx
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atrial trigeminy
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describe junctional bigeminey
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when you have a premature junctional beat following every normal pqrst
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if you have a premature QRS with no P wave or an inverted P wave and the QRS duration is .10s this is a premature___ beat
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junctional
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if you have a premature QRS with no P wave and the QRS duration is.14s you would label this a premature_____ contraction
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ventricular
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if the ventricular foci are irritable and the pt shows no signs of hypoxia you would expect the pt may be _____
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hypokalemic
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if you suspect that the pt is having PVC's what will the pulse feel like
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you should feel an extra pulse every time there is a PVC
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normal PR interval
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.2s or 5 small boxes or one large box
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if th PR interval exceeds .2s what do you suspect
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Some type of AV block ( first degree block
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what is a first degree block
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whan the AVnode holds the impulse from the atria or SA node for a peiod longer than normal ( widened PR interval)
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Type 1 second degree block is also known as
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wenckebach block
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tpe 2 second degree block is also known as
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mobitz block
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which heart block is also known as a classical heart block
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mobitz type 2 second degree heart block
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easiest way to spot a third degree block
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p waves and QRS are disassociated
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Which heart block is also known as a complete heart block
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third degree heart block
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severe hyperkalemia can cause what rythm
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asystole
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easiest way to tell rythm is not ventricular in nature
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normal QRS duration or a QRS that is less than .12s
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if you see a wide QRS complex with two Rwaves this indicates
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a bundle branch block
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if you suspect a budle branch block you should check which leads
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V-1, V-2,& V-5 V-6
R & L chest leads |
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if any PR interval exceeds one large squre you have some kind of ____
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block
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the first two things you should check on every EKG
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PR interval and QRS duration
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leads 2,3 & AVF are considered ____ leads
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inferior
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leads AVL & 1 are considered ____ leads
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lateral
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chest leads measure on a ____ plane
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horizontal
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myocardial infarction, coronary occlusion, and heart attack all have what in common
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thay are essentially all the same thing
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inverted T wave indicates
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ischemia
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ischemia, injury, and necrosis together are considered the ___ ___ ___
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nyocardial infarction triad
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characteristic sign of ischmia
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inverted T wave
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diminished coronary blood flow will show up how on an EKG
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inverted T wave
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flat T waves or minimal T wave inversion in a limb lead may indicate what when viewed in limb leads
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nothing most likely normal
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the term injury means what in relation to time when reading an ecg
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recent or acute
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ST segment eleveted indicates
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injury (infarct)
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earliest consistent sign of an infarct
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elevated ST segment
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Prinzmetals angina
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angina with out excertion
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BBB
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bundle branch block
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RBBB with ST segment elevationin leads V1, V2, V3
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brogada syndrome
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what drug can cause a depressed ST segment
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digitalis
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nearly 59% of sudden deaths due to heart disese in healthy young people is due to
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brugada syndrome
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drug treatments for asthma in normal order
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albeuterol, atrovent, solumedrol, MAG
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normal drug treatments for COPD/CHF/Pulmonary edema in order
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lasix, nitro, morphine,positive pressure ventilation
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normal drug treatments for pneumonia in order given
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oxygen, NS
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VOMIT
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vitals, oxygen, monitor, IV, transport
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drug treatments for torsades de pointes in order given
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MAG
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drug treatments for PEA in order given
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EPI 1:10,000, Atropine(3 rounds) Vasopressin ( substituted for 1st or 2nd round of epi or not at all),amiodarone, lidocaine
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EPI dose for braycardia
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2-10 mcg/min titrate for effect
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drug treatment for angina in order
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oxygen, ASA, nitro, morphine
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mneumonic for drug treatment for angina
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MONA
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MONA
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morphine, oxygen, nitro, aspirin
|
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what drug is used for chemical cardioversion
|
adenosine
|
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drug treatment for pulseless V-tach/V-fib/ PVC's in order given
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lidocaine, amiodarone (if lidocaine does not work), DEFIB
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EKG rythm that may look a lot like a ribbon, cheyne stokes respirations or a voice recording
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torsades de pointes
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drug treatment for asystloe
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epi/atropin three round every 5 minutes, conitnue with epi every 5 minutes after 3 round
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only treatment for a heart block
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TCP
|
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TCP
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transcutaneous pacing
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drug treatment for 2nd degree heart block
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none TCP is only treatment
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drug treatment for pt whos rythm is PVC's only and has a pulse
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non if you resolve PVC's you may remove pulse (VOMIT)
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1 box on the EKG strip is equal to how much time
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0.04seconds
|
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normal P wave duration
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less than .12s
|
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ST segment is what on the EKG
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line between end of QRS and beginng of T wave( do not confuse ST segment elevation with a large T wave)
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what should you suspect if the ST segment is elevated 1mm above isoelctric line
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myocardial ischemia
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|
a tall sharply peaked T wave indicates
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hyperkalemia
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the beginnig of the QRS until the end o the T wave is the ____
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Q-T interval
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a prolonged Q-T interval may indicate
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AMI/hypocalcemia/pericarditis
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normal Q-T interval duration
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0.36-0.44s (9-11 boxes)
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prolonged Q-T interval exceeds how many boxes
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more than 11
|
|
PAC
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premature atrial complex/contraction
|
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tachy cardia of unknown origin is labeled as a ____
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SVT
|
|
in order for a tachy rythm to be considered an SVT the rate must exceed
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150bpm
|
|
PSVT
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witnessed SVT
|
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key to identifying A-fib
|
R-R intervals are regularly irregular
|
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PR interval longer then .12s indicates
|
first degree block
|
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if you pt is on warfarin/coumadin you should not be supised to see what type of rythm
|
A-fib
|
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number one concern with A-fib
|
blood clots
|
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no palpable pulse-rate of 20-40, no P waves, widened QRS Dx
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idioventricular rythm
|
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regular rythm,no P waves, QRS qreater than .12s, rate greater than 100 Dx
|
V-tach
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the most common polymorphic V-tach seen
|
torsades de pointes
|
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rate greater then 100,QRS complex varies in height and pattern Dx
|
torsades de pointes
|
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if pt is in fine v-ib what does this tell you
|
heart has been without oxygen for some time
|
|
lead that is placed over the 4th intercostal space at the right sternal border
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v-1
|
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lead place over the 4th ntercostal space at the left sternal border
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V-2
|
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V-3 is placed where
|
between V-2 & V-4
|
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lead that is placed over the 5th intercostal at the midclavicular line
|
V-4
|
|
lead placed at the anterior axillary in line wtih V-4
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V-5
|
|
lead placed at the midaxillary line in line with V-4
|
V-6
|
|
if you are unable to identify a tachycardia as an SVT or V-tach how should it be treated
|
As V-tach
|
|
the Ron T phenomenom will cause a pt to go into
|
V-fib
|
|
if you are cardioverting a pt and he goes into v-fib what should you do
|
prepare to defib immediately
|