MED SURG > EXAM > Advanced Med Surg Exam 1 - Questions and Answers (All)

Advanced Med Surg Exam 1 - Questions and Answers

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Advanced Med Surg Exam 1 - Questions and Answers First degree AV block -A delay in the conduction of the depolarizing impulse from the SA node to the ventricles, prolonging the PR interval due to an... anatomical or functional impairment in conduction system -most common heart block and least threatening Second degree type 1 AV block -This type shows with a progressively increasing PR interval that eventually ends in a dropped QRS complex. -usually a temporary condition that can be asymptomatic -To treat, we offer reassurance (since it isn't life-threatening). Second degree type 2 AV block constant PR interval with missing QRS complexes -complete block of conduction in one bundle branch and an intermittent block in other -can present as a pattern -caused by damage to bundles Third Degree (Complete) Heart Block P wave is normal but not related to QRS Third degree heart block treatment Emergent temporary pacemaker until stable, then permanent pacemaker. NOT TREATABLE WITH ATROPINE What causes third degree heart block? Inferior wall MI, Ischemic Heart Disease, Medications (Dig, BB, CCB), hyperkalemia TB symptoms Flulike symptoms, night sweats, elevated temperature, decreased deep tendon reflexes. Risk factors for TB immunocompromised, substance abuse, emigration from country with high prevalence TB classifications 0=no TB exposure 1= TB exposure no infection 2=latent TB 3=TB, clinically active (contagious) 4=TB, but not clinically active 5=TB suspect TB assessment latent TB: positive skin test, no symptoms active TB: fatigue, anorexia, frequent cough, chest pain, chills, night sweats, high fever crackles, dullness on percussion What is a positive TB test? positive= greater than or equal to 15 mm or greater than or equal to 5 mm in immunocompromised individuals TB diagnostic tests Mantoux skin test- assess for induration in 48-72 hours chest x-ray sputum cultures-induced sputum (gold standard) TB medications Isoniazid Rifampin Pyrazinamide Ethambutol How do we protect ourselves form TB pt needs to be in negative pressure room we need to wear N95, gloves, gown pt needs 3 negative sputums to be taken off precautions [Show More]

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