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Pre-CRT III
Hemodynamic Monitoring and the Heart
| Question | Answer |
|---|---|
| What is it called when your heart skips a beat, has irregular rhythm, normal P waves and QRS complex missing? | 2nd Degree Heart Block |
| How is 2nd Degree Heart Block Treated? | Atropine and and electrical pacemaker |
| What is it when the PR interval cannot be determined and the QRS complex is widened? | 3rd Degree Heart Block |
| How is 3rd Degree Heart block treated | Electrical Pacemaker |
| What degree of block slows you down, pauses between the P wave to the QRS complex? | 1st Degree Heart block |
| How is 1st Degree Heart block treated | Atropine |
| What does an inverted T-wave mean | Myocardial Ischemia |
| What does significant Q waves mean? | Myocardial Infarction |
| What do elevated S-T segments mean | Myocardial Injury |
| Where is the SA Node located? | Upper right hand corner of the heart. |
| How does the electrical impulse travel through the heart | Moves through atria causing contraction (P-wave), then it is received by AV node, delayed (P-R interval). Stimulus is sent through bundle of His and L&R bundle branches to purkjunke fibers (QRS) after short delay (S-T) the heart depolarizes (T-wave). |
| How do you treat Asystole | Confirm in 2 leads first, epinephrine , Atropine and CPR |
| How do you treat Sinus Bradycardia | Oxygen, Atropine |
| How do you treat Sinus Tachycardia | Oxygen |
| How do you treat PVC | Oxygen, Lidocaine |
| How do you treat multifocal PVC | Oxygen, Lidocaine |
| How do you treat Ventricular Tachycardia | If no pulse De-fibrillate If pulse Lidocaine, Cardioversion |
| How do you treat Ventricular Fibrillation | De-fibrillate |
| Where do you place the Chest Electrodes V1 for an EKG | 4th intercostal space on R side of sternum |
| Where do you place the Chest Electrodes V2 for an EKG | 4th intercostal space on L side of sternum |
| Where do you place the Chest Electrodes V3 for an EKG | Between V2 and V4 on left side |
| Where do you place the Chest Electrodes V4 for an EKG | 5th intercostal space,left mid-clavicular line |
| Where do you place the Chest Electrodes V5 for an EKG | Between V4 and V6 on left side |
| Where do you place the Chest Electrodes V6 for an EKG | 5th intercostal space, left mid-axillary line |
| Two factors that affect the direction of the axis | Hypertrophy and Infarction |
| What is the normal axis of the hearts electrical impulse | Down and to the left |
| What are the 4 Chambers of the Heart | Left Ventricle Right Atria Right Ventricle Left Atria |
| The Left Ventricle serves what branch | systemic arteries |
| The Right Atria serves what branch | systemic veins |
| The Right ventricle serves what branch | pulmonary arteries |
| The Left Atria serves what branch | pulmonary veins |
| What are the 3 factors which control blood pressure | Heart, Blood and vessels |
| How does the heart increase BP | when the rate increases |
| How does blood increase BP | when there is fluid overload |
| How do vessels increase BP | when there is constriction of the vessels |
| How does the heart decrease BP | When it is not pumping hard enough |
| How does blood decrease BP | Loss of blood |
| How do the vessels decrease BP | when there is dilation of the vessels |
| List two methods used for measuring MAP | Indwelling arterial catheter with a pressure transducer. |
| The left heart is associated with what disease | CHF |
| The right heart is associated with what disease | Cor Pulmonale |
| What is pulse pressure | The difference between the systolic and diastolic pressure |
| What is Cardiac Output (QT) | Measures the output of the left ventricle to systemic arterial circulation |
| What is SVR-Systemic Vascular Resistance | The pressure gradient across the systemic circulation divided by the cardiac output |
| What is PVR - Pulmonary Vascular Resistance | The pressure gradient across the pulmonary circulation divided by the cardiac output |
| What causes PVR to increase | hypoxia, pulmonary hypertension and lung disease |
| What is the Normal Cardiac output range | 4-8 LPM |
| What is the normal Cardiac Index range | 2.5-4.0 liters/min/m2 |
| The first heart sound S1 is created by what | Normal closure of the mitral and tricuspid valves at the beginning of ventricular contraction |
| The second heart sound S2 is created by what | Systole ends. The ventricles relax and the pulmonic and aortic valves close. |
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