Telemetry exam 1|153 Questions with Verified Answers,100% CORRECT

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Telemetry exam 1|153 Questions with Verified Answers Right atrium: oxygenated or deoxygenated? - CORRECT ANSWER deoxygenated right ventricle: oxygenated or deoxygenated? - CORRECT ANSWER deoxyge ... nated Left atrium: oxygenated or deoxygenated? - CORRECT ANSWER oxygenated left ventricle: oxygenated or deoxygenated? - CORRECT ANSWER oxygenated pulmonary artery: oxygenated or deoxygenated? - CORRECT ANSWER deoxygenated aortic arch: oxygenated or deoxygenated? - CORRECT ANSWER oxygenated superior vena cava: oxygenated or deoxygenated? - CORRECT ANSWER oxygenated inferior vena cava: oxygenated or deoxygenated? - CORRECT ANSWER deoxygenated pulmonary vein: oxygenated or deoxygenated? - CORRECT ANSWER oxygenated atrioventricular valves - CORRECT ANSWER mitral and tricuspid what heart sound do the atrioventricular valves produce? - CORRECT ANSWER makes S1 or "lub" semi-lunar valves - CORRECT ANSWER pulmonary and aortic what heart sounds do the semi-lunar valves produce? - CORRECT ANSWER S2 or "DUB" automaticity - CORRECT ANSWER ability to make an impulse excitability - CORRECT ANSWER ability to respond to an impulse conductivity - CORRECT ANSWER ability to transmit energy from one cell to another what sets the rate for the heart and what is normal rate? - CORRECT ANSWER determined by the fastest firing node SA node: 60-100 what node fires at a rate of 40-60? - CORRECT ANSWER AV node what "pacemaker" fires the slowest? what are the norms for this node? - CORRECT ANSWER ventricular: 30-40 identify 5 stage of action potential - CORRECT ANSWER 1. rapid depolarization 2. early repolarization 3. plateau phase 4. rapid repolarization 5. resting phase 1. rapid depolarization - CORRECT ANSWER sodium moves RAPIDLY into cells, calcium moves SLOWLY into cells 2. early repolarization - CORRECT ANSWER sodium channels close 3. plateau phase - CORRECT ANSWER calcium continues to flow in, potassium flows out of cell 4. rapid repolarization - CORRECT ANSWER calcium channels close, potassium flows out RAPIDLY 5. resting phase - CORRECT ANSWER active transport through sodium-potassium pump- restores potassium in cell and sodium to outside of cell, cell membrane becomes impermeable to sodium, potassium may move out of cell what EKG wave is reflective of atrial depolarization? - CORRECT ANSWER p what EKG wave is reflective of ventricular depolarization? - CORRECT ANSWER QRS what is the significance of the ST segment? - CORRECT ANSWER represents the interval between ventricular depolarization and repolarization what is the significance of the QT wave? - CORRECT ANSWER measurement that represents the total time from ventricular depolarization to complete repolarization cardiac ouput - CORRECT ANSWER amount of blood ejected from a ventricular in liters/minutes cardiac output norms - CORRECT ANSWER 4-6 liters 3 factors that influence cardiac ouput - CORRECT ANSWER heart rate stroke volume autonomic NS preload - CORRECT ANSWER amount of blood in ventricles at end of diastole what factors increase preload? - CORRECT ANSWER hypertension fluid replacement what factors decrease preload? - CORRECT ANSWER bleeding diuretics vasodilators dehydration afterload - CORRECT ANSWER resistance to ejection of blood from ventricle frank-starling law - CORRECT ANSWER The greater the stretch, the stronger is the heart's contraction. This increased contractility results in an increased volume of blood ejected (Increased SV) ejection fraction - CORRECT ANSWER percent of end diastolic volume ejected with each heartbeat ejection fraction norms - CORRECT ANSWER left ventricle 55-65% ejection fraction points of concern - CORRECT ANSWER less than 40% means ventricular function should begin treatment for heart failure mean arterial pressure - CORRECT ANSWER average pressure with arterial system felt by organs what is required to perfuse organs - CORRECT ANSWER MAP 60 needed to perfuse vital organs age-related changes atria - CORRECT ANSWER increased atria/thickens age related changes: left ventricle - CORRECT ANSWER fibrosis/hypertrophy/fat age related changes: valves - CORRECT ANSWER thick/rigid/calcify age related changes: conduction - CORRECT ANSWER decreased conduction cells age related changes: sympathetic nervous system - CORRECT ANSWER decreased responses age related changes: aorta/arteries - CORRECT ANSWER stiffens/decreased elasticity age related changes: baroreceptor response - CORRECT ANSWER decreased receptors increased atria/thickens functional change - CORRECT ANSWER increased irritability fibrosis/hypertrophy/fat left ventricle functional change - CORRECT ANSWER decreased output prolonged systole less compliant thick/rigid/calcify valves functional changes - CORRECT ANSWER altered blood flow decreased conductance cells functional changes - CORRECT ANSWER decreased impulses decreased responses functional change - CORRECT ANSWER decreased contractility/heart rate decreased response oxygen stiffens/decreases elasticity aorta/arteries functional changes - CORRECT ANSWER left ventricular hypertrophy decreased receptors baroreceptor response functional change - CORRECT ANSWER poor regulation of heart rate/vascular tone angina triggers - CORRECT ANSWER exertion emotion meals angina remedy - CORRECT ANSWER rest/nitroglycerine ACS: reperfusion pericarditis triggers - CORRECT ANSWER sudden onset pain with inspiration, swallowing, rotating pericarditis remedy - CORRECT ANSWER sit upright anti-inflammatory medications pulmonary triggers - CORRECT ANSWER increases with inspirations, coughing, movement occurs with lung infections pulmonary remedy - CORRECT ANSWER treat underlying cause esophageal triggers - CORRECT ANSWER laying down cold liquid exercise esophageal remedy - CORRECT ANSWER antacids nitroglycerine anxiety triggers - CORRECT ANSWER anytime triggers anxiety remedy - CORRECT ANSWER relaxation remove stimuli treat anxiety musculoskeletal triggers - CORRECT ANSWER respiratory infection idiopathic musculoskeletal remedy - CORRECT ANSWER rest ice heat anti-inflammatory medications non-modifiable cardiovascular risk factors - CORRECT ANSWER ethnicity age gender family history modifiable risk factors - CORRECT ANSWER abdominal obesity high blood pressure diabetes high cholesterol psychosocial factors smoking Gordan's functional patterns - CORRECT ANSWER elimination activity and exercise sleep and rest self-perception and self-concept roles and relationships sexuality and reproduction coping and stress assessment findings for atrial/ventricular problems - CORRECT ANSWER jugular venous distention peripheral edema ascites crackles postural hypotension assessment findings for cardiac ouput - CORRECT ANSWER clubbing cold/cool skin and diaphoresis cool/pale/painful fingers/toes cyanosis ecchymosis/bruising edema pallor red-blue discoloration of legs ulcers xanthelasma assessment findings for acute arterial obstruction - CORRECT ANSWER pain pallor pulselessness parethesia poliothermia paralysis what values are significant for BMI - CORRECT ANSWER BMI over 30 what values are significant for waist circumference - CORRECT ANSWER male waist circumference over 40 female waist circumference over 35 inches cause of clubbing - CORRECT ANSWER chronic desaturation what disease processes might you suspect in clients displaying jugular vein distention? - CORRECT ANSWER right sided heart failure hypervolemia pulmonary hypertension pulmonary stenosis shock hypovolemia mitral regurgitation mitral/aortic stenosis how are preload and cardiac output being impacted with change in position? - CORRECT ANSWER since cardiac output is equal to the product of stroke volume and heart rate, with increased preload the cardiac output is increased die to the increase in stroke volume pulse pressure - CORRECT ANSWER the difference between systolic and diastolic blood pressure Increases stroke volume - CORRECT ANSWER An increased preload decreased stroke volume - CORRECT ANSWER decreased cardiac output S1 - CORRECT ANSWER closure of AV valves S2 - CORRECT ANSWER closure of semi-lunar valves S3 - CORRECT ANSWER associated with heart failure 1. tricuspid area: left sided heart failure 2. apical/left lateral: left sided heart failure S4 - CORRECT ANSWER gallops are best heart with bell lightly against the chest 1. atria forcing blood into the left ventricle lungs impact the heart - CORRECT ANSWER hemoptysis cough crackles wheeze 1. may be compression on vessels or narrowing from beta-blockers liver impact the heart - CORRECT ANSWER fluid accumulation or enlarged, tender liver may indicate right-sided heart failure, pulsating may indicate-aaa kidney impact the heart - CORRECT ANSWER check for edema in bedridden cleints what cardiac biomarker is most indicate of a myocardial infarction? - CORRECT ANSWER creatine kinase (CK) CK isoensymes (CK-MB) proteins (Troponin T) what is the value of BUN and creatine to cardiac assessment - CORRECT ANSWER elevated BUN and creatine=renal impairment normal creatine and increased BUN= intravascular fluid volume deficit magnesium - CORRECT ANSWER 1.8-3.0 magnesium significance - CORRECT ANSWER helps absorb calcium, maintain potassium, metabolism ATP potassium - CORRECT ANSWER 3.5-5.5. potassium significance - CORRECT ANSWER cardiac electrophysiology sodium - CORRECT ANSWER 135-145 Sodium Significance - CORRECT ANSWER impacts fluid levels PTT - CORRECT ANSWER 60-70 seconds PTT significance - CORRECT ANSWER goal: adjust heparin 1.5-2.5 times baseline adjust less than 50 or more than 1000 PT - CORRECT ANSWER 9.5-12 seconds PT significance - CORRECT ANSWER monitor anticoagulation INR - CORRECT ANSWER 1 INR significance - CORRECT ANSWER monitor warfarin therapeutics with PT goal 2-3.5 VDL - CORRECT ANSWER View Definition Language - Specifies user views/mappings to conceptual schema LDL - CORRECT ANSWER low density lipoprotein (bad cholesterol) HDL - CORRECT ANSWER high density lipoproteins (healthy type of cholesterol) what are patient considerations specific to cardiac stress testing? - CORRECT ANSWER 48 hours post MI uncontrolled dysthymias with hemodynamic compromise severe aortic stenosis myocarditis/pericarditis decompensating heart failure 3-5 leads what is monitored - CORRECT ANSWER give up a quick simple view and basic understanding of heart rhythm 12 leads what is monitored - CORRECT ANSWER picture in picture view of the heart 15 leads what is monitored - CORRECT ANSWER additional leads are added to the right side of the chest indicate right ventricular/left posterior ventricular infarction 18 lead what is monitored - CORRECT ANSWER three posterior leads reflect myocardial ischemia/injury why do we use holter monitors? - CORRECT ANSWER cardiac events recorders indicate sensations in the movement what are the benefits of telehealth with recorders and implantable devices? - CORRECT ANSWER use from home or that doctors use to improve or support health care services implantable devices 1. web portal 2. implantable loop recorder what steps are important prior to/during lead placement why? - CORRECT ANSWER debride clip hair connect leads to wires peel backing of leads 1. it is sticky consider anatomic position 1. change every 24 hours 5 lead monitor placement - CORRECT ANSWER white-right upper chest black- left upper arm green- right lower chest red-left lower chest brown-middle snow over grass smoke over fire earth in the middle 12 lead EKG placement - CORRECT ANSWER • Limb (extremity) electrodes and placement o RA right arm (aVr)- anywhere between the right shoulder and wrist o LA left arm (aVL)- anywhere between the left shoulder and wrist o LL left leg (aVF)- anywhere between the left lower torso to left ankle o RL right leg- anywhere between the right lower torso and right ankle • Chest (precordial) electrodes and placement o V1- fourth intercostal space right sternum o V2- fourth intercostal space left sternum o V4- fifth intercostal space midclavicular line o V3- place between V2 and V4 o V6- mid axillary line at 5th intercostal space o V5- place in line between V4 and V6 ekg leads should not be placed over what 3 areas - CORRECT ANSWER bones scars high muscle areas what considerations should be in place to eliminate artifact? - CORRECT ANSWER explain the process settle the patient eliminate 1. artifact 2. interference 3. environmental concerns how many big boxes make a 3 second strip? - CORRECT ANSWER 15 boxes how many big boxes make a 6 second strip? - CORRECT ANSWER 30 boxes a 1 second strip can be measured by how many big boxes? - CORRECT ANSWER 5 boxes one large box is reflective of how much time? - CORRECT ANSWER 0.2 each tiny is reflective of how much time? - CORRECT ANSWER 0.04 how is a PR interval measured? - CORRECT ANSWER count the boxes what range does a normal PR interval fall into? - CORRECT ANSWER 0.12-0.2 atrial depolarization how is a QRS measured and what range does a normal? - CORRECT ANSWER 0.08-0.12 how is a QT interval measured and what values are considered normal? - CORRECT ANSWER 0.325-0.43 what causes tall P waves? - CORRECT ANSWER increased left atrial pressure or atrial dilation what conditions may cause notched or wide P waves? - CORRECT ANSWER increased left atrial pressure or atrial dilation what two conditions may cause individuals to experience longer PR interval? - CORRECT ANSWER heart block digoxin toxicity what are causes for wide QRS? - CORRECT ANSWER severe hyperkalemia drug toxicity what conditions result from missing QRS complexes? - CORRECT ANSWER sinus arrest a client with ST segment depression should be evaluated for what condition - CORRECT ANSWER injury your EKG indicated ST segment elevation. what should you do - CORRECT ANSWER stemi what variables may alter QT length? - CORRECT ANSWER prolonged: 1. torsades de pointe 2. class 1a antiarrhythmics shortend: 1. digoxin toxicity 2. hypercalcemia what five step process should be applied when dissecting EKG strips? - CORRECT ANSWER determine a rhythm is the rhythm regular/irregular identify the P wave measure PR interval evaluate QRS what are 3 variable which impact the SA node? - CORRECT ANSWER vagus nerve sympathetic nerve parasympathetic nerve how do respirations impact sinus arrhythmia? - CORRECT ANSWER inspiration 1. increases blood flow, decreased tone, increased heart rate expiration 1. decrease venous return, increased vagal tone, slower heart rate what medical conditions may result in sinus arrhythmia? - CORRECT ANSWER inferior wall MI advanced age digoxin/morphine conditions with increased intracranial pressure what 5 conditions and 2 medications which may cause sinus brady cardia? - CORRECT ANSWER electrolyte disorders SA nodal disease Sleep MI Valsalva maneuver beta blockers calcium channel blockers what conditions may cause tachycardia? - CORRECT ANSWER pain hypovolemia myocardial infarction hemorrhage what assessment findings might you anticipate seeing in clients with tachycardia? - CORRECT ANSWER anxiety chest pain/palpitation hypotension/syncope crackles/heart failure as a general rule of protection and erroring on the safe side, what interventions should be in place or close by if needed? - CORRECT ANSWER assess patient-are they symptomatic? are they stable? give oxygen and monitor saturation monitor blood pressure and heart rate start IV if not already established notify MD why do we use synchronized cardioversion? - CORRECT ANSWER if the patient if possible or defibrilation how should we administer adenosine? - CORRECT ANSWER first dose: 6 mg rapid Iv push; follow with NS flush. second dose: 12 mg if required what are non-invasive methods to attempt to slow down the heart rate? how would you perform them? - CORRECT ANSWER vagal maneuvers -Valsalva maneuver: hold nose, close mouth, try to blow air out -cough -gag -hold knees against chest -carotid sinus massage: lie down and stick out chin. put pressure on carotid sinus. adenosine beta blockers/calcium channel blockers what is the difference between sinus pause and sinus arrest? - CORRECT ANSWER sinus pause: 1-2 beats missing sinus arrest: more than 3 beats missing you are notified your patient has experienced severe sinus arrests. what physical sinus arrests. what physicals assessment findings might you see? - CORRECT ANSWER asymptomatic low cardiac output dizzy/syncope cool/clammy skin your patient is symptomatic sinus arrest. what interventions will you take to care for the patient? - CORRECT ANSWER lower head of bead administer atropine/epinephrine consider digoxin or betablocker toxicity/electrolyte imbalance what physicals findings may be present in clients with sick sinus? - CORRECT ANSWER crackles S3 heart sounds lightheaded/syncope what are least invasive and most invasive treatment options for clients with sick sinus? - CORRECT ANSWER atropine/epinephrine pacemaker what are signs and symptoms of emboli? - CORRECT ANSWER pain shortness of breath tachypnea tachycardia confusion visual disturbances clients susceptible for an embolus should receive what treatment? - CORRECT ANSWER anticoagulation [Show More]

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